Notice of Privacy Practices
How We Use and Protect Your Health Information
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Effective Date: December 4, 2024
Our Duty to Protect Your Health Information
We are required by law to maintain the privacy and security of your protected health information (PHI). We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. We must follow the duties and privacy practices described in this notice and give you a copy of it. We will not use or share your information other than as described here unless you tell us we can in writing.
How We May Use and Disclose Your Health Information
Treatment
We may use and disclose your health information to provide, coordinate, or manage your healthcare and related services. This includes consultations with other healthcare providers and referrals for care.
Payment
We may use and disclose your health information to obtain payment for services provided. As a cash-pay practice, this primarily involves billing you directly or providing receipts for your records.
Healthcare Operations
We may use and disclose your health information for our healthcare operations, including quality assessment, training, licensing, and accreditation activities.
Other Uses and Disclosures
We may also use or disclose your health information:
- As required by law
- For public health activities (disease reporting, FDA notifications)
- To report abuse, neglect, or domestic violence
- For health oversight activities
- In response to court orders or subpoenas
- To law enforcement under specific circumstances
- To coroners, medical examiners, and funeral directors
- For organ and tissue donation purposes
- For workers' compensation claims
- To avert a serious threat to health or safety
- For specialized government functions (military, national security)
Uses Requiring Your Written Authorization
We will obtain your written authorization before using or disclosing your PHI for:
- Marketing purposes
- Sale of your health information
- Most uses of psychotherapy notes
- Other purposes not covered by this notice
You may revoke your authorization at any time in writing, except to the extent we have already acted upon it.
Your Rights Regarding Your Health Information
Right to Access
You have the right to inspect and obtain a copy of your health information. We may charge a reasonable fee for copies.
Right to Amend
You may request an amendment to your health information if you believe it is incorrect or incomplete.
Right to an Accounting
You have the right to receive a list of disclosures we have made of your health information.
Right to Request Restrictions
You may request restrictions on how we use or disclose your health information. We are not required to agree to all requests.
Right to Confidential Communications
You may request that we communicate with you in a specific way or at a specific location.
Right to a Paper Copy
You have the right to obtain a paper copy of this notice upon request.
Right to File a Complaint
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of Health and Human Services.
Special Protections for Sensitive Information
Certain types of health information receive additional protections under state and federal law:
- Mental Health Records: Additional restrictions apply to mental health treatment records
- Substance Abuse Records: 42 CFR Part 2 provides additional protections for substance use disorder treatment records
- HIV/AIDS Information: Florida law provides special protections for HIV-related information
- Genetic Information: GINA provides protections against genetic discrimination
Changes to This Notice
We reserve the right to change this notice at any time. Any changes will apply to information we already have about you as well as any information we receive in the future. The revised notice will be available upon request and on our website.
Privacy Officer Contact
For questions about this notice or to exercise your rights, contact our Privacy Officer:
File a Complaint
If you believe your privacy rights have been violated, you may file a complaint with:
Bravely Balanced Privacy Officer
(850) 399-2299
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
1-800-368-1019
You will not be retaliated against for filing a complaint.
Ready to Get Started?
Your privacy is our priority. Contact us today to schedule your consultation.
(850) 399-2299