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MINDHEALTH BEHAVIORAL PLLC

NOTICE OF PRIVACY PRACTICES

Effective Date: August 24, 2026

  1. 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.

  2. Our Commitment to Your Privacy

    MINDHEALTH BEHAVIORAL PLLC (“we,” “us,” or “our practice”) 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 with respect to your PHI, and to notify you following a breach of unsecured PHI. We are required to abide by the terms of this Notice while it is in effect.

  3. How We May Use and Disclose Your Health Information

    We may use and disclose your PHI for the following purposes without obtaining your specific authorization:

    • Treatment: To provide, coordinate, or manage your psychiatric care and any related services, including sharing information with other treating providers involved in your care.
    • Payment: To bill and collect payment for services from you, your insurance company, Medicaid, Medicare, or another third-party payer.
    • Health Care Operations: For internal purposes such as quality assessment, staff training, licensing, and business management.
    • Appointment Reminders and Treatment Alternatives: To contact you about appointments or to provide information about treatment options or health-related benefits and services.
    • Required by Law: When disclosure is required by federal, state, or local law, including reporting as required by public health authorities.
    • Health and Safety: To prevent or lessen a serious and imminent threat to the health or safety of a person or the public, consistent with applicable law.
    • Judicial and Administrative Proceedings: In response to a court order, subpoena, or other lawful process, as permitted by law.

    Certain categories of information, including psychotherapy notes (if maintained separately from the medical record) and substance use disorder treatment records, receive additional protections under federal and state law and generally require your specific written authorization before disclosure, even for treatment, payment, or health care operations, except in limited circumstances permitted by law.

  4. Uses and Disclosures Requiring Your Written Authorization

    Other than as described above, we will not use or disclose your PHI without your written authorization. This includes, in most circumstances, psychotherapy notes, uses for marketing purposes, and disclosures that constitute a sale of PHI. You may revoke a prior authorization, in writing, at any time, except to the extent we have already relied upon it.

  5. Your Rights Regarding Your Health Information

    You have the following rights with respect to your PHI:

    • Right to Request Restrictions: You may request restrictions on certain uses and disclosures of your PHI. We are not required to agree to all requests, except in certain circumstances required by law.
    • Right to Request Confidential Communications: You may request that we communicate with you about your health information in a certain way or at a certain location.
    • Right to Access: You have the right to inspect and obtain a copy of your PHI maintained in your medical and billing records, with limited exceptions.
    • Right to Amend: You may request an amendment of your PHI if you believe it is incorrect or incomplete. We may deny your request under certain circumstances.
    • Right to an Accounting of Disclosures: You may request a list of certain disclosures we have made of your PHI.
    • Right to a Paper Copy: You have the right to obtain a paper copy of this Notice upon request, even if you agreed to receive it electronically.
    • Right to be Notified of a Breach: You have the right to be notified in the event of a breach of your unsecured PHI.

  6. How to Exercise Your Rights or File a Complaint

    To exercise any of the rights described above, or to file a complaint if you believe your privacy rights have been violated, please contact us using the information below. You may 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.

  7. Changes to This Notice

    We reserve the right to change this Notice and to make the revised Notice effective for PHI we already have as well as any information we receive in the future. The current Notice will be available at our office and on our website.

  8. Contact Information

    MINDHEALTH BEHAVIORAL PLLC
    311 W 24th St., Charlotte, NC 28206
    Phone: 980-844-8885
    Email: [email protected]