Notice of Privacy Practices

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.

Mind Body Spirit- DPC, PLLC (“Practice”) is required by law to maintain the privacy of your protected health information, provide you with this notice of our legal duties and privacy practices, and follow the terms of the notice currently in effect.

Your rights

You have the right to:

• Get a copy of your paper or electronic medical recordYou can ask to see or get a copy of your medical record and other health information we maintain about you, subject to limited legal exceptions.
• Ask us to correct your medical recordYou can ask us to correct health information about you that you believe is incorrect or incomplete. We may deny your request in some circumstances, but we will explain why in writing if required.
• Request confidential communicationsYou can ask us to contact you in a specific way, such as at a particular phone number, email address, mailing address, or through another reasonable method.
• Ask us to limit what we use or shareYou can ask us not to use or share certain health information for treatment, payment, or health care operations. We are not always required to agree, except where the law requires otherwise.
• Get a list of certain disclosuresYou can ask for an accounting of certain disclosures we made of your information.
• Get a copy of this privacy noticeYou can ask for a paper copy of this notice at any time, even if you agreed to receive it electronically.
• Choose someone to act for youIf you have given someone medical power of attorney or if someone is your legal guardian, that person may exercise your rights to the extent permitted by law.
• File a complaint if you believe your rights have been violatedYou may file a complaint with us and/or with the U.S. Department of Health and Human Services Office for Civil Rights.

Your choices

For certain health information, you may tell us your choices about what we share. For example, where applicable, you may ask us about sharing information with:

• Family members, friends, or others involved in your care
• Disaster relief organizations
• Communications about appointment reminders, treatment alternatives, or health-related benefits and services

If you are not able to tell us your preference, we may share information if we believe it is in your best interest, as permitted by law.

We will obtain your written authorization for uses and disclosures not otherwise permitted or required by law, including most uses of psychotherapy notes if applicable, most uses of protected health information for marketing where authorization is required, and the sale of protected health information if ever applicable.

You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.

Our uses and disclosures

We typically may use or share your health information in the following ways:

• TreatmentWe may use your health information to provide, coordinate, or manage your health care and related services.
• Health care operationsWe may use or disclose your health information to run our practice, improve care, manage records, conduct quality activities, and perform business operations.
• Appointment reminders and health-related communicationsWe may contact you with appointment reminders, follow-up information, care coordination messages, or information about treatment alternatives or health-related services.
• Business associatesWe may share information with vendors or contractors who perform services for us and are required to protect your information appropriately.

Other ways we may use or share your information

We may also use or disclose your information when allowed or required by law, including:

• To comply with federal, state, or local law
• For public health activities
• To report abuse, neglect, or domestic violence where permitted or required
• For health oversight activities
• For judicial or administrative proceedings
• For law enforcement purposes in limited circumstances
• For organ and tissue donation as permitted by law
• For medical examiners, coroners, or funeral directors as permitted by law
• For certain research purposes as permitted by law
• To avert a serious threat to health or safety
• For workers’ compensation claims
• For specialized government functions where permitted by law

Special considerations

We may maintain information in paper and electronic form. We may communicate through secure electronic systems, patient portals, secure messaging vendors, telemedicine platforms, and other tools used to support your care.

For highly sensitive information that may be subject to additional protections under applicable law, we will handle it in accordance with those additional requirements.

Our responsibilities

We are required by law to:

• Maintain the privacy and security of your protected health information
• Provide you with this notice
• Follow the duties and privacy practices described in this notice
• Notify affected individuals following a breach of unsecured protected health information when required by law

We will not use or share your information other than as described here unless you tell us we can in writing, or unless the law otherwise permits or requires it.

Changes to this notice

We may change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available in our office and on our website.

Complaints

If you believe your privacy rights have been violated, you may contact:

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

Contact information

Acknowledgment of receipt

The Acknowledgment of Receipt is an enrollment document completed through Hint, the practice's membership and enrollment system. It is not part of this website: this site provides no signature form and collects no health information or other personal information.