Creative Art Therapy Place, PLLC

16 Cypress Ave

Brooklyn, NY 11237

(347) 292-1085

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

I. MY PLEDGE REGARDING HEALTH INFORMATION:

I understand that health information about you and your health care is personal. I am committed to protecting health information about you. I create a record of the care and services you receive from me. This notice applies to all records of your care generated by this mental health care practice. This notice explains the ways in which I may use and disclose health information about you and your rights to the health information I maintain.

I am required by law to:

  • Make sure that protected health information ("PHI") that identifies you is kept private.

  • Give you this notice of my legal duties and privacy practices with respect to health information.

  • Follow the terms of the notice that is currently in effect.

  • Provide you with updated information regarding privacy practices, including protections for reproductive health care services in accordance with New York State law.

I can change the terms of this Notice, and such changes will apply to all information I have about you. The new Notice will be available upon request, in my office, and on my website.

II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:

For Treatment, Payment, or Health Care Operations:

I may use or disclose your PHI without your written authorization for treatment, payment, or health care operations. Examples include:

  • Sharing information with other health care providers for consultation.

  • Billing and payment processing for services rendered.

  • Conducting internal quality assessment activities.

Lawsuits and Disputes:

If you are involved in a legal dispute, I may disclose health information in response to a court or administrative order, subpoena, or other legal request.

III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:

Psychotherapy Notes:

Any use or disclosure of psychotherapy notes requires your authorization, except under the following circumstances:

  • For my use in treating you.

  • For training and supervision purposes.

  • For defense in legal proceedings initiated by you.

  • As required by law or to prevent a serious threat to health or safety.

Marketing and Sale of PHI:

  • I do not use or disclose your PHI for marketing or sell your PHI in the regular course of business.

IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION:

I may use and disclose your PHI without your authorization in the following circumstances:

  • When required by law (e.g., public health reporting, abuse or neglect reporting, responding to law enforcement requests, or health oversight activities).

  • For judicial or administrative proceedings (e.g., court orders, subpoenas, or compliance investigations).

  • For health oversight activities (e.g., audits or inspections).

  • For specialized government functions (e.g., military or national security operations).

  • For workers' compensation claims.

  • For appointment reminders and treatment alternatives.

V. REPRODUCTIVE HEALTH PRIVACY PROTECTIONS UNDER NEW YORK STATE LAW:

As per New York State Senate Bill S470, additional protections apply to reproductive health services:

  • Your reproductive health care information is considered confidential.

  • I will not disclose any reproductive health services you receive without your explicit consent, unless required by law.

  • You have the right to access and control information regarding your reproductive health care.

  • Law enforcement and out-of-state entities are prohibited from requesting your reproductive health records in certain circumstances, protecting you from legal consequences related to services received in New York.

If you have concerns about the privacy of your reproductive health information, you may request additional confidentiality protections.

VI. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT:

  • Disclosures to family, friends, or others: I may disclose PHI to a person involved in your care unless you object.

VII. YOUR RIGHTS WITH RESPECT TO YOUR PHI:

You have the following rights:

  • The Right to Request Limits on Uses and Disclosures of Your PHI.

  • The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full.

  • The Right to Choose How I Send PHI to You.

  • The Right to See and Get Copies of Your PHI.

  • The Right to Get a List of the Disclosures I Have Made.

  • The Right to Correct or Update Your PHI.

  • The Right to Get a Paper or Electronic Copy of this Notice.