Notice of Privacy Practices

Our commitment to your privacy

Soulful Horizon LCSW, PLLC is required by law to maintain the privacy of your protected health information (PHI), to provide you with this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect.

How we may use and disclose your information

• Treatment — to provide, coordinate, or manage your care and related services.
• Payment — to bill and collect payment for the services you receive, including verifying insurance coverage.
• Health care operations — to support quality, administrative, and business activities necessary to run the practice.
• As required by law — including mandatory reporting of abuse, threats of harm to self or others, and valid court orders.

Uses that require your written permission

Other uses and disclosures not described in this notice, including most uses of psychotherapy notes, uses for marketing, and any sale of your information, will be made only with your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted on it.

Your rights

You have the right to:

• Request access to and a copy of your records.
• Request corrections to your health information.
• Request restrictions on certain uses and disclosures.
• Restrict disclosures to your health plan about services you have paid for in full, out of pocket.
• Request confidential communications by alternative means or at alternative locations.
• Receive an accounting of certain disclosures.
• Obtain a paper copy of this notice upon request.
• Be notified if a breach of your unsecured health information occurs.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us using the contact information below, or with the U.S. Department of Health and Human Services Office for Civil Rights by writing to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting hhs.gov/ocr/complaints. We will not retaliate against you for filing a complaint.

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 current notice is always available on this page and on request.

Contact us

To exercise any of these rights or to ask questions about this notice, contact our Privacy Officer, Emmanuelle Lajeunesse, LCSW, at 929-900-3880 or info@soulfulhorizon.com.