Effective Date: September 20, 2013
THIS NOTICE DESCRIBES HOW YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED, AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

I. Our Commitment to Your Privacy

• At Embody + Mind Collective, we understand that your health information is personal. We are committed to protecting your privacy and maintaining the confidentiality of your health records. This Notice describes how we may use and disclose your health information and outlines your rights related to that information.

We are legally required to:

• Keep your protected health information (PHI) private.
• Provide you with this Notice describing our legal duties and privacy practices.
• Follow the terms outlined in this Notice.
• Inform you of any changes to these practices; updates will be available upon request, in our office, and on our website.

II. How We May Use and Disclose Your Health Information

For Treatment, Payment, and Health Care Operations:
We may use and disclose your health information without written authorization for the purposes of treatment, payment, or operational needs. For example:

• Consulting with another health care provider about your condition.
• Coordinating care with other professionals or third-party services.
• Processing insurance claims and managing administrative tasks.

Note: For treatment purposes, providers may access the full record as necessary to provide quality care.

Lawsuits and Legal Proceedings:
 If you are involved in a legal matter, we may disclose health information in response to a court or administrative order. We may also respond to a subpoena or legal request after notifying you or obtaining protective orders, when required.

III. Uses and Disclosures That Require Your Authorization
Psychotherapy Notes:

•  Use or disclosure of psychotherapy notes requires your specific authorization, except in limited circumstances such as:
• For treatment purposes.
• Clinical supervision and training.
• Legal defense.
• Compliance reviews by the Department of Health and Human Services.
• As required by law or for safety concerns.

Marketing and Sale of PHI:
We will not use or disclose your PHI for marketing purposes or sell your PHI.

IV. Uses and Disclosures That Do Not Require Authorization
We may use or disclose your health information without your authorization when required or permitted by law, including:

• Public health activities, such as reporting abuse or preventing serious threats.
• Health oversight activities, including audits and investigations.
• Judicial proceedings, as required by law.
• Law enforcement purposes, such as reporting crimes.
• Coroner or medical examiner duties.
• Research purposes, when approved by governing bodies.
• Specialized government functions, including national security and corrections.
• Workers’ compensation, in accordance with legal requirements.
• Appointment reminders and health-related services, such as letting you know about treatment options or wellness programs.

V. Disclosures That Allow You to Object
Disclosures to Family or Others Involved in Your Care:

•  We may share information with a family member, friend, or caregiver involved in your care or payment unless you object. In emergencies, we may proceed and confirm with you later.

VI. Your Rights Regarding Your PHI

• Right to Request Limits: You may request that we limit how we use or disclose your PHI. While we are not required to agree, we will consider all reasonable requests.
• Right to Restrict for Self-Pay: If you paid in full out-of-pocket, you can request that we do not disclose that information to your insurance company.
• Right to Confidential Communications: You can ask us to contact you in a specific way (e.g., home vs. mobile phone) or send mail to a different address.
• Right to Access Records: You may request a paper or electronic copy of your health record, excluding psychotherapy notes. We will respond within 30 days and may charge a reasonable, cost-based fee.
• Right to an Accounting of Disclosures: You can request a list of disclosures made over the past six years (not including disclosures for treatment, payment, or operations).
• Right to Amend Records: If you believe your record is incorrect or incomplete, you may request a correction. We will respond within 60 days.
• Right to a Copy of this Notice: You have the right to receive this Notice by email or in paper form, even if you initially chose email delivery.

Under HIPAA, you have the right to understand how your information is used and protected.