Notice of Privacy Practices

Effective Date: August 29, 2026 

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. 

1. Our Commitment to Your Health Information 

Our clinic is dedicated to maintaining the privacy of your Protected Health Information (PHI). In the course of providing care, we create records regarding you and the treatment and services we provide to you. We are legally required to maintain the confidentiality of medical information that identifies you, provide you with this notice of our legal duties and privacy practices, and follow the specific privacy terms currently in effect. 

2. How We May Use and Disclose Your PHI 

The following categories describe the different ways we may use and disclose your PHI without obtaining your specific written authorization: 

• Treatment: We may use your PHI to provide, coordinate, or manage your medical treatment. For example, we may disclose medical info to a specialist we refer you to, or to a pharmacist filling your prescription. 

• Payment: We may use and disclose your PHI so that the treatment and services you receive may be billed to and payment collected from you, an insurance company, or a third party. For example, your health plan may need details about a procedure to verify coverage. 

• Healthcare Operations: We may use and disclose PHI to run our clinic efficiently and ensure all patients receive quality care. Examples include evaluating coordinator performance, quality assessment audits, or training medical students. 

• Appointment Reminders & Service Alternatives: We may use your PHI to contact you via phone, email, or text to remind you of an appointment, or to inform you about treatment options or health-related benefits. By signing this form and providing your phone number, you agree to receive SMS customer care and account notifications from Psych NP PLLC. Message frequency may vary. Standard Message and Data Rates may apply. Reply STOP to opt out. Reply HELP for help. Consent is not a condition of care or treatment. No mobile information will be shared with third parties/affiliates for promotional or marketing purposes. All other categories exclude text messaging originator opt-in data and consent; this information will not be shared with any third parties.

3. Special Disclosures Required or Permitted by Law 

Under federal and Colorado state law, we may release your PHI without authorization in the following situations: 

• Public Health Risks: To prevent or control disease, injury, or disability; report vital events; or notify individuals of recalls. 

• Law Enforcement & Legal Proceedings: In response to a warrant, legal subpoena, court order, or administrative mandate. 

• Abuse or Neglect: We are mandated reporters under Colorado law. We must disclose PHI to notify government authorities if we suspect child abuse, elder abuse, or mistreatment of an at-risk adult. 

• Health Oversight Activities: To oversight agencies for activities authorized by law, such as audits, investigations, inspections, and licensure. 

• To Avert a Serious Threat: When necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. 

4. Strict Colorado Privacy Act (CPA) Alignments 

While HIPAA strictly governs medical treatment records, any non-treatment, health-related retail data, wellness enrollment data, or consumer web communications gathered by our clinic fall under the jurisdiction of the Colorado Privacy Act (CPA). We do not sell consumer data, utilize your web metrics for third-party behavior profiling, or process sensitive personal data without affirmative opt-in consent. 

5. Your Rights Regarding Your PHI 

You possess the following rights regarding the medical information we maintain about you: 

• Right to Inspect and Copy: You have the right to inspect and obtain a physical or electronic copy of your medical and billing records. Requests must be submitted in writing. We may charge a reasonable, cost-based fee. 

• Right to Amend: If you feel medical info we have is incorrect or incomplete, you may ask us to amend it. The request must be in writing and provide a supporting reason. 

• Right to an Accounting of Disclosures: You may request a list of certain non-routine disclosures we made of your PHI for purposes other than treatment, payment, or operations. 

• Right to Request Restrictions: You have the right to request a restriction on our use or disclosure of PHI. We are not required to agree, except if you request we withhold disclosures to a health plan for payment purposes and you have paid out-of-pocket in full. 

• Right to Confidential Communications: You can request that we communicate with you about medical matters in a specific way or at a specific location (e.g., home phone only). 

6. Right to File a Complaint 

If you believe your privacy rights have been violated, you may file a formal complaint with our clinic's Privacy Officer or directly with the Secretary of the Department of Health and Human Services (HHS). You will not be penalized or retaliated against for filing a complaint.