Privacy Practices

Notice of Privacy Practices

(Please read very carefully)

As a Licensed RTT Practitioner provider, I am required by federal and state laws to protect your privacy. The Health Information Portability and Accountability Act (HIPAA) establishes limits on how your health information may be used and shared; and how it must be protected. When Florida laws protecting your health records are more restrictive than federal laws, I must abide by the Florida laws.

The following Notice of Privacy Practices will tell you about the ways I may use and share any personal/health information about you. I also describe here your rights and my duties regarding the use and disclosure of your personal/health information.

My Pledge to You Regarding Your personal Health Information

The privacy of your personal/health information is important to me. I create a record of our session together that will be deleted after one year from the day of the session. There will be an audio recording that you will need to listen to for 21 days and will be deleted after a week from the date it is emailed to you. This record enables me to provide you with quality transformation and to comply with certain legal requirements. I understand that this information is personal and I am committed to protecting it.

This Notice of My Privacy Practices Describes

Your Protected Health Information

Your Protected Health Information includes any individually identifiable information I create or receive about you. Specifically it includes:

Use and Disclosure of Your Protected Health Information Without your specific written consent

  • I will not share your Protected Health Information with another practitioner, therapist or treatment facility, unless it is a recommendation for better or more specialized treatment/care.
  • I will not share your Protected Health Information with any other individual, including family members, except in the case of minor children.
  • I am required to report child and elder abuse and/or neglect to the proper authorities. This report, may of necessity, include your Protected Health Information.
  • I am required to take action, including the release of your Protected Health Information, if I believe that you or someone else is imminently at risk of harm.
  • I may share your Protected Health Information with individuals or entities who participate in the management of my practice. Each of these people has agreed to abide by the terms of my Notice of Privacy Practices.
  • I may release your Protected Health Information to medical personnel in a medical emergency.
  • I may release your Protected Health Information for these additional purposes; public health, health/safety, activities, national security, military activities, patient directories, law enforcement, judicial proceedings, correctional facilities, health care oversight, workers’ compensation, coroner/ funeral activities, family members or others involved in your care, research, when required by law.

Your Privacy Rights

With the exception of the purposes listed above, you have the right to decide if your Protected Health Information is given out to a third party and to specify what information is to be given. You do this by completing and signing the Consent to Use or Disclose Protected Health Information form. You may revoke this consent at any time.

You have the right to review and get copies of your Protected Health Information. Your request must be in writing. There may be charges for copying and postage. Your request may be denied if I think that giving you your Protected Health Information may endanger your life or physical safety or that of another person.

You may request that corrections or additions be made to your Protected Health Information if you believe that there is a significant omission. You or another health professional may add information to your record, but nothing will be removed from your Protected Health Record. Under HIPPA regulations, your request does not require me to change anything in your health records. However, if I deny your request, I will provide you with a written explanation. If I accept your request to change or to add information, I will make reasonable efforts to tell others, including people you name, of the change/addition and to include the change/addition in any future sharing of your Protected Health Information.

You may request additional restrictions on my use of disclosure of your Protected Health Information. But, I, as your health care provider, am not required to agree to these additional restrictions if I have substantial reasons for not honoring your request.

You may request that I use an alternative way to communicate with you in a confidential manner or communicate with you at an alternative location about your protected health Information. Make your request in writing to my attention.

You may obtain a list of the times I have disclosed your health information for purposes other than treatment, payment, healthcare operations and other specified exceptions.

You will receive a copy of my Notice of Privacy Practices via email.

You have the right to file a written complaint if you believe I have violated your privacy rights. You may submit a written complaint to the Florida Department of Health. If you chose to do this, we will provide you with the address to file your complaint with the Florida Department of Health. Your decision to file a complaint will not be held against you in any way. However, it may be necessary for us to discuss whether it is possible or ethical for us to continue in a relationship.

My Legal Duty

I am required to abide by the terms of this notice. However, I reserve the right to change my privacy practices and the terms of this notice at any time provided the changes are permitted by law or to meet any new requirements implemented by law for the benefit of your Protected Health Information.

Before I make any important changes to my privacy practices, I will revise this notice and make the new notice available to you on your first visit following the revisions.

Any changes to my privacy practices and the new terms of this notice will be effective from the date of the revision forward for all personal/health information I keep. You may have a copy of these notices by requesting it from me.