Notice of Privacy Practices

Psychology Partners Group Effective Date: January 1, 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.

OUR PLEDGE REGARDING HEALTH INFORMATION

We understand that information about you and your health is personal. We are committed to protecting health information about you. This Notice applies to all of the records of your care generated by Psychology Partners Group.

YOUR RIGHTS

When it comes to your health information, you have certain rights:

  • Get a copy of your health and claims records: You can ask to see or get a copy of your medical record and other health information we have about you. We will provide a copy or a summary, usually within 30 days. We may charge a reasonable, cost-based fee.
  • Ask us to correct your medical record: You can ask us to correct health information about you that you think is incorrect or incomplete. We may say “no,” but we’ll tell you why in writing within 60 days.
  • Request confidential communications: You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
  • Ask us to limit what we use or share: You can ask us not to use or share certain health information for treatment, payment, or our operations.
    • Note: If you pay for a service out-of-pocket in full, you can ask us not to share that information with your health insurer. We will say “yes” unless a law requires us to share it.
  • Get a list of those with whom we’ve shared information: You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
  • Get a copy of this privacy notice: You can ask for a paper copy of this notice at any time.
  • File a complaint if you feel your rights are violated: You can complain by contacting our Privacy Officer at [Insert Email/Phone]. You can 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.

YOUR CHOICES

For certain health information, you can tell us your choices about what we share:

  • In these cases, you have both the right and choice to tell us to:
    • Share information with your family, close friends, or others involved in your care.
    • Share information in a disaster relief situation.
  • In these cases we NEVER share your information:
    • Marketing purposes or the sale of your information.
    • Psychotherapy Notes: Most uses and disclosures of psychotherapy notes (notes made by your therapist during a private session) require your written authorization.

OUR USES AND DISCLOSURES

How do we typically use or share your health information?

  • To Treat You: We can use your health information and share it with other professionals who are treating you (e.g., a primary care physician).
  • To Run Our Organization: We can use and share your health information to run our practice, improve your care, and contact you when necessary.
  • To Bill For Your Services: We can use and share your health information to bill and get payment from health plans or other entities.

How ELSE can we use or share your health information? We are allowed or required to share your information in other ways that contribute to the public good, such as:

  • Reporting suspected abuse, neglect, or domestic violence.
  • Preventing or reducing a serious threat to anyone’s health or safety.
  • Complying with state or federal law (including workers’ compensation).
  • Responding to lawsuits, court orders, or subpoenas where applicable and with your knowledge.

MANDATORY 2026 DISCLOSURES

  • Substance Use Disorder (SUD) Records: To the extent that we create or maintain SUD records protected under 42 CFR Part 2, we will not share that information for civil, criminal, administrative, or legislative investigations or proceedings against you without your written consent or a court order and subpoena.
  • Notice of Potential Redisclosure: Once we disclose your health information to a third party at your request (such as to an employer or school), that information may no longer be protected by federal privacy laws and could be redisclosed by the recipient.

OUR RESPONSIBILITIES

  • We are required by law to maintain the privacy and security of your protected health information.
  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
  • We must follow the duties and privacy practices described in this notice.

CONTACT INFORMATION

If you have questions or wish to exercise your rights, please contact: Privacy Officer: Emily Bly Email: info@psychologypartnersgroup.com Phone: (347) 560-4628