HIPAA
Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY
We are required by law to protect the privacy of protected health information, to provide individuals with notice of our legal duties and privacy practices regarding this information, and to notify affected individuals in the event of a breach of unsecured protected health information. We must follow the privacy practices described in this Notice while it is in effect. This Notice takes effect on February 16, 2026, and will remain in effect until it is replaced.
We reserve the right to change our privacy practices and the terms of this Notice at any time, as long as the changes are permitted by applicable law. Any new provisions may apply to all protected health information that we maintain. If we make a significant change to our privacy practices, we will update this Notice, post the revised version clearly and prominently at our practice location, and provide copies upon request.
You may request a copy of this Notice at any time. For more information about our privacy practices or to obtain additional copies of this Notice, please contact us using the information provided at the end of this Notice.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
We may use and disclose your health information for various purposes, including treatment, payment, and healthcare operations. For each category, we provide a description and example below. Certain types of information—such as HIV-related information, genetic information, alcohol and/or substance use disorder treatment records, and mental health records—may receive special confidentiality protections under applicable state or federal law. We will comply with all such special protections when they apply.
Treatment
We may use and disclose your health information to provide, coordinate, or manage your treatment. For example, we may share your health information with a specialist who is involved in your care.
Payment
We may use and disclose your health information to obtain payment for the treatment and services you receive from us or other providers involved in your care. Payment activities may include billing, collections, claims management, and determining eligibility or coverage to obtain payment from you, your insurance company, or another third party. For example, we may submit claims to your dental or health plan that include certain health information.
Healthcare Operations
We may use and disclose your health information in connection with our healthcare operations. These activities include quality assessment and improvement initiatives, staff training, licensing, credentialing, and other business management functions.
Individuals Involved in Your Care or Payment for Your Care
We may disclose your health information to family members, friends, or other individuals you identify who are involved in your care or payment for your care. We may also share information with a patient representative. If someone has legal authority to make healthcare decisions for you, we will treat that person as we would treat you with respect to your health information.
Disaster Relief
We may use or disclose your health information to assist in disaster relief efforts.
Required by Law
We may use or disclose your health information when required to do so by federal, state, or local law.
Public Health Activities
We may disclose your health information for public health purposes, including to:
Prevent or control disease, injury, or disability;
Report child abuse or neglect;
Report reactions to medications or issues with products or medical devices;
Notify individuals of recalls, repairs, or replacements of products or devices;
Notify individuals who may have been exposed to a disease or condition; or
Alert appropriate government authorities if we believe a patient has been a victim of abuse, neglect, or domestic violence.
National Security and Military Activities
We may disclose the health information of Armed Forces personnel to military authorities under certain circumstances. We may also disclose information to authorized federal officials for lawful intelligence, counterintelligence, and national security activities. Additionally, we may disclose protected health information (PHI) to correctional institutions or law enforcement officials who have lawful custody of an inmate or patient.
Secretary of Health and Human Services (HHS)
We will disclose your health information to the Secretary of the U.S. Department of Health and Human Services when required to investigate or determine compliance with HIPAA regulations.
Workers’ Compensation
We may disclose your PHI as authorized and necessary to comply with laws relating to workers’ compensation or other similar programs established by law.
Law Enforcement
We may disclose your PHI for law enforcement purposes as permitted by HIPAA, as required by law, or in response to a subpoena or court order.
Health Oversight Activities
We may disclose your PHI to government oversight agencies for activities authorized by law, such as audits, investigations, inspections, and licensure reviews. These activities are necessary for monitoring the healthcare system, government programs, and compliance with civil rights laws.
Judicial and Administrative Proceedings
If you are involved in a lawsuit or dispute, we may disclose your PHI in response to a court or administrative order. We may also disclose health information in response to a subpoena, discovery request, or other lawful process, provided efforts have been made to notify you or to secure a protective order regarding the requested information.
Research
We may disclose your PHI to researchers when the research has been approved by an institutional review board or privacy board that has established protocols to protect your privacy.
Coroners, Medical Examiners, and Funeral Directors
We may release your PHI to a coroner or medical examiner to identify a deceased person or determine the cause of death. We may also disclose PHI to funeral directors as permitted by law to allow them to carry out their duties.
Fundraising
We may contact you about our sponsored activities, including fundraising programs, as permitted by law. If you prefer not to receive such communications, you may opt out at any time.
SUD TREATMENT INFORMATION
If we receive or maintain information about you from a substance use disorder treatment program covered by 42 CFR Part 2 (a “Part 2 Program”) through a general consent you provide to that program for purposes of treatment, payment, or healthcare operations, we may use and disclose your Part 2 Program record for those purposes as described in this Notice. If we receive or maintain your Part 2 Program record through a specific consent you provide to us or to another third party, we will use and disclose that record only as expressly permitted in your written consent.
Under no circumstances will we use or disclose your Part 2 Program record, or any testimony describing the information contained in that record, in civil, criminal, administrative, or legislative proceedings conducted by any Federal, State, or local authority against you, unless you have authorized it in writing or a court issues an order after providing you with notice.
OTHER USES AND DISCLOSURES OF PHI
Your written authorization is required, with limited exceptions, for the disclosure of psychotherapy notes, the use or disclosure of PHI for marketing purposes, and for the sale of PHI. We will also obtain your written authorization before using or disclosing your PHI for purposes not described in this Notice, unless otherwise permitted or required by law. You may revoke your authorization in writing at any time. Once we receive your written revocation, we will stop using or disclosing your PHI, except to the extent that we have already relied on your authorization.
YOUR HEALTH INFORMATION RIGHTS
Access
You have the right to inspect or obtain copies of your health information, with limited exceptions. Your request must be submitted in writing. You may use the contact information at the end of this Notice to obtain a request form or send us a written letter. If we maintain your information on paper, we may provide photocopies. If we maintain it electronically, you have the right to receive an electronic copy. We will provide the information in the form and format you request if it is readily producible. A reasonable, cost-based fee may be charged for copying, supplies, labor, and postage if mailed. If your request for access is denied, you have the right to have the denial reviewed in accordance with applicable law.
Disclosure Accounting
You have the right to receive an accounting of certain disclosures of your health information as required by law. To request this accounting, you must submit a written request to the Privacy Official. If you request more than one accounting within a 12-month period, we may charge a reasonable, cost-based fee for additional requests.
Right to Request a Restriction
You have the right to request restrictions on our use or disclosure of your PHI by submitting a written request to the Privacy Official. Your request must specify (1) the information you want restricted, (2) whether you want to limit use, disclosure, or both, and (3) to whom the limits apply. We are generally not required to agree to your request, except when the disclosure is to a health plan for payment or healthcare operations and relates solely to services that you (or someone on your behalf, other than the health plan) have paid for in full.
Alternative Communication
You have the right to request that we communicate with you about your health information using alternative methods or at different locations. Your request must be in writing and explain how payments will be handled under the requested alternative. We will accommodate all reasonable requests. However, if we are unable to contact you using your requested method or location, we may use the information available to us.
Amendment
You have the right to request an amendment to your health information. Your request must be in writing and explain the reason for the amendment. We may deny your request in certain circumstances. If we approve your request, we will amend your record and notify you. If we deny your request, we will provide a written explanation and inform you of your rights.
Right to Notification of a Breach
You will be notified of any breach of your unsecured protected health information as required by law.
Electronic Notice
You may request a paper copy of this Notice at any time, even if you previously agreed to receive it electronically via our website or email.
QUESTIONS AND COMPLAINTS
If you would like more information about our privacy practices or have questions or concerns, please contact us using the information listed at the end of this Notice.
If you believe your privacy rights have been violated, or if you disagree with a decision we made regarding access to your health information or a request to amend, restrict, or communicate your information differently, you may file a complaint with us using the contact information provided at the end of this Notice. You may also submit a written complaint to the U.S. Department of Health and Human Services. We will provide the appropriate address upon request.
We support your right to privacy and will not retaliate against you for filing a complaint with us or with the U.S. Department of Health and Human Services.