Notice of Privacy Practices

Your rights

• Request a paper or electronic copy of your clinical record.
• Ask for a correction to information you believe is inaccurate or incomplete.
• Request confidential communications by a reasonable method or at a different address.
• Ask for limits on certain uses or disclosures, including qualifying services paid in full out of pocket.
• Request an accounting of certain disclosures made during the applicable period.
• Receive a paper copy of this notice and choose an authorized representative.
• File a complaint without retaliation.

Your choices

In circumstances where the law gives you a choice, Safe Haven Therapy will ask how you want information shared. Written authorization is generally required for uses of psychotherapy notes, marketing uses, sale of protected health information, and other uses not described in this notice. You may revoke an authorization in writing, except to the extent action has already been taken.

Permitted uses and disclosures

Protected health information may be used or disclosed for treatment, payment, and health care operations, and when permitted or required for public health and safety, oversight, legal proceedings, law enforcement, workers' compensation, or other duties established by law. Only the information reasonably necessary for the purpose will be used or disclosed when that limitation applies.

Mental health records, psychotherapy notes, and substance-use-disorder records may receive additional federal or state protection. Those protections will be followed when they apply. Safe Haven Therapy does not sell protected health information.

Our responsibilities

• Maintain the privacy and security of protected health information.
• Notify affected individuals after a breach when required.
• Follow the duties and privacy practices described in the current notice.
• Provide this notice electronically and make a paper copy available on request.

The notice may be changed, and a revised notice may apply to information already held. The current version will be posted here. Platforms involved in care or payment, including Alma and health plans, maintain their own notices for information they control.

Questions or complaints

Privacy contact: Shelby Harvey, LCSW. Email [email protected] to exercise a right, request a paper copy, ask for a telephone contact, or make a complaint.

A complaint may also be filed with the U.S. Department of Health and Human Services Office for Civil Rights. Safe Haven Therapy will not retaliate for filing a complaint.

This notice follows the current HHS model notice guidance.