Notice of Privacy Practices (HIPAA)

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.

Our Duties

We are required by law to maintain the privacy of your protected health information (PHI), to give you this notice of our legal duties and privacy practices, to follow the terms of the notice currently in effect, and to notify you if a breach compromises the privacy of your PHI.

How We May Use and Disclose PHI

### Without your written authorization

**Treatment:** to provide and coordinate your care, including with other providers involved in it.

**Payment:** to bill and collect payment for your services.

**Healthcare operations:** to run the practice, such as quality improvement, staff training, and internal audits.

**Appointment reminders:** to contact you about upcoming sessions.

**As required by law:** for example court orders, mandated reporting of abuse or neglect, and public health reporting.

**To prevent serious harm:** when necessary to avert a serious threat to your health or safety or that of others.

### Only with your written authorization

Most uses and disclosures of psychotherapy notes, uses of your PHI for marketing, and any sale of your PHI require your written authorization. Any other use or disclosure not described in this notice also requires your written authorization. You may revoke an authorization in writing at any time, except where we have already acted on it.

Your Rights

You have the right to:

• **Request restrictions** on how we use or share your PHI. We will consider your request but are not always required to agree.

• **Restrict disclosures to your health plan** for services you have paid for in full out of pocket.

• **Receive confidential communications** at a particular address or by a particular means.

• **Inspect and get a copy** of your records, with limited exceptions.

• **Request an amendment** to your records if you believe information is incorrect or incomplete.

• **Receive an accounting** of certain disclosures we have made.

• **Receive a paper copy** of this notice on request.

• **File a complaint** with us or with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

How to Exercise Your Rights

Send requests in writing to hello@siblingcarecounseling.com, or call (305) 505-2381.

Contact

• Privacy Officer, Sibling Care Counseling

• Email: hello@siblingcarecounseling.com

• Phone: (305) 505-2381

Changes to This Notice

We may change this notice. Changes apply to all PHI we maintain, and the revised notice will be posted on our website.