Notice of Privacy Practices

Your Information. Your Rights. Our Responsibilities.

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.

Your Rights

You have the right to:

  • Get a copy of your medical record
  • Correct your medical record
  • Request confidential communications
  • Ask us to limit what we use or share
  • Get a list of those with whom we’ve shared your information
  • Get a copy of this privacy notice
  • Choose someone to act for you
  • File a complaint if you believe your privacy rights have been violated

Your Choices

You have some choices in the way that we use and share information as we:

  • Tell family and friends about your condition (with your consent)
  • Provide disaster relief information
  • Include you in a patient directory (if applicable)
  • Share mental health information (with your consent or as legally required)
  • Market our services and sell your information (only with your written permission)

Our Uses and Disclosures

We may use and share your information as we:

  • Treat you (e.g., share information with another healthcare provider involved in your care)
  • Run our organization (e.g., use data to improve your care and manage services)
  • Bill for your services (e.g., send information to your insurance company)

We are also allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For example:

  • Preventing disease or reporting abuse or neglect
  • Health oversight activities, such as audits and investigations
  • Legal proceedings and law enforcement requests
  • Research (under strict privacy safeguards)
  • Compliance with workers’ compensation laws
  • Responding to legal requests, subpoenas, or court orders

We will never:

  • Share your psychotherapy notes without your written authorization (except in limited circumstances permitted by law)
  • Use your information for marketing purposes without your written consent
  • Sell your information

Our Responsibilities

  • 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 your information.
  • We must follow the duties and privacy practices described in this notice.
  • We will not use or share your information other than as described here unless you tell us we can in writing.

Changes to the Terms of This Notice

We may change the terms of this notice at any time. The new notice will apply to all information we have about you. We will provide the updated notice in our office and on our website (if applicable). You may request a paper copy at any time.

Contact and Complaints

If you have questions or complaints about this notice or how your information is handled, you may contact:

Privacy Officer: Brianna Hall
Phone: 360-930-9480
Email: brianna@whipplecreekwellness.com

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at www.hhs.gov/ocr/privacy/hipaa/.... We will not retaliate against you for filing a complaint.

Acknowledgment of Receipt

I acknowledge that I have received and reviewed this Notice of Privacy Practices.