June 24, 2025

Notice of Privacy Practices 

In this document: AXTUALISED refers to the owner, administration staff, affiliates, and contractual partners and hereto referred to as “we” “our” “us”

We are providing you with this notice, as required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA). As a health care provider, HIPAA requires AXTUALISED to respect and protect patient “protected health information” or “PHI” and requires us to be transparent with you regarding our practices concerning our collection, use and sharing of PHI obtained from or about you. HIPAA also requires us to make you aware of your privacy rights, including your ability to exercise your choice (i.e., “consent,” also referred to as an “authorization”) and provide your permission for us to collect, use, or share your PHI. This Notice further states the obligations we have to protect your health information.

“Protected health information” means health information (including identifying information about you) we have collected from you or received from your health care providers, health plans, your employer or a health care clearinghouse. It may include information about your past, present, or future physical or mental health or condition, the provision of your health care, and payment for your health care services. We are required by law to maintain the privacy of your health information and to provide you with this notice of our legal duties and privacy practices with respect to your health information. We are also required to comply with the terms of our current Notice of Privacy Practices.

CONSENT TO USE AND DISCLOSE YOUR HEALTH INFORMATION

This is an agreement between you, the client, and AXTUALISED. AXTUALISED refers to the owner, administration staff, affiliates, or contractual partners. As a client of AXTUALISED you will be asked to provide what the law calls Protected Health Information (PHI) about yourself. At AXTUALISED, we require this information to plan and provide the best treatment for you. There are times when AXTUALISED may share this information with others who provide treatment to you. AXTUALISED will also use this information to arrange payment for your treatment via insurance or for other business or government functions. When you agree to treatment, you agree to let AXTUALISED use your information as noted above. The Notice of Privacy Practices/HIPPA explains in more detail your rights and how AXTUALISED can use and share your information. You can request a copy of this policy at any time.

In the future AXTUALISED may change how we use and share your information and so may change our Notice of Privacy Practices/HIPPA.

You may be asked to sign specific releases for collateral contacts or for permission for AXTUALISED to coordinate with for continuity of care. After you have signed this consent, you have the right to revoke it (by writing a statement to inform AXTUALISED you no longer consent), AXTUALISED will comply with your wishes about using or sharing your information from that point on, however, please be aware that AXTUALISED may have already shared some of your information for care coordination and AXTUALISED is not responsible for what has been already shared prior to revocation of release. AXTUALISED is not held liable for what others do with your personal information that you may have disclosed or the information AXTUALISED has disclosed in accordance with laws and guidance.

Patient’s Rights

1. Treatment is voluntary and you have a right not to enter into services with AXTUALISED.
2. You have the right to decide to end our treatment at any time without prejudice. If you wish, I will provide you with the names of other qualified Clinicians.
3. You have the right to refuse the use of any therapeutic technique offered. AXTUALISED will inform you of intent to use any unusual procedures and will explain any risks involved.
4. You have the right to learn about alternative methods of treatment. AXTUALISED will discuss these with you as appropriate.

Confidentiality

Anything you discuss is considered privileged information and will be held in confidence by AXTUALISED. AXTUALISED will not release any information to others about you unless you give AXTUALISED explicit written permission by signing a “release of information” form. Please be aware that there are certain situations in which we are required by law to reveal information without your permission; Such uses or disclosures may be in oral, paper or electronic format.

For Treatment. AXTUALISED may use and disclose your health information to provide you with mental health treatment or services or to assist in the coordination, continuation or management of your care and any related services. This includes the coordination or management of your health care with a third party. For example, a health care provider, such as a licensed professional counselor, or other person providing health services to you, will record information in your record that is related to your treatment and may share that information with other providers. This information is necessary for other health care providers to determine what treatment you should receive.

For Payment. AXTUALISED may use and disclose your health information to others for the purposes of obtaining payment for treatment and services that you receive. For example, a bill may be sent to you or to a third-party payer, such as an insurance AXTUALISED or health plan, for services provided to you. The information on the bill may contain information that identifies you, your diagnosis, and treatment.

For Health Care Operations. AXTUALISED may use and disclose health information about you for operational purposes.

Communications. AXTUALISED may use and disclose your information to provide appointment reminders, leave a message on your answering machine, or leave a message with an individual who answers the phone at your residence. We may, from time to time, contact you to provide information about treatment alternatives and services that may be of interest to you. We may also provide you with informational materials including information about AXTUALISED. Material may come from a third party.

Required or Permitted by Law. AXTUALISED may use and disclose information about you as required or permitted by law. If a use or disclosure is required by law, the use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. If required by law, you will be notified of any such uses or disclosures. For example, AXTUALISED may use and/or disclose information for the following purposes:

Public Health. Your health information may be used or disclosed for public health activities such as: (1) assisting public health authorities or other legal authorities to prevent or control disease, injury, or disability; (2) reporting child abuse or neglect to a public health authority or other governmental authority that is authorized by law to receive such reports; and (3) notifying a person who may be at risk of contracting or spreading a disease, if such disclosure is authorized by law.

Individuals involved in your care. We may provide information about you to a family member, friend, or other person involved in your health care or in payment for your health care. If you are deceased, we may disclose medical information about you to a friend or family member who was involved in your medical care prior to your death, limited to information relevant to that person’s involvement, unless doing so would be inconsistent with your written wishes you previously provided to us. If we disclose information to a family member, relative or close friend, we will disclose only information that we believe is relevant to that person’s involvement with your health care or payment related to your health care.

HIPAA permits AXTUALISED to disclose to other health providers any PHI contained in the medical record about an individual for treatment, case management, and coordination of care and, with few exceptions, treats mental health information the same as other health information. HIPAA generally does not limit these disclosures except that AXTUALISED must obtain individuals’ authorization to disclose separately maintained psychotherapy session notes for such purposes. AXTUALISED will abide by all applicable state law or professional practice standards that place additional limitations on disclosures of PHI related to mental health.

Health Oversight Activities. To a health oversight agency for audits, investigations, inspections, licensing purposes, or as necessary for certain government agencies to monitor the health care system, government programs, and compliance with civil rights laws.

Health and Safety: Duty to Warn. We may, consistent with applicable law and standards of ethical conduct, use or disclose health information about you if we believe that the use or disclosure is necessary to prevent or lessen a serious threat to the health or safety of a person or the public; provided that, if a disclosure is made, it must be to a person(s) reasonably able to prevent or lessen the threat and is permissible by law.

HIPAA permits AXTUALISED to notify a patient’s family members of a serious and imminent threat to the health or safety of the patient or others if those family members are able to lessen or avert the threat. To the extent that a provider determines that there is a serious and imminent threat of a patient physically harming self or others, HIPAA would permit the provider to warn the appropriate person(s) of the threat, consistent with his or her professional ethical obligations and State law requirements.  Even where danger is not imminent, HIPAA permits a covered provider to communicate with a patient’s family members, or others involved in the patient’s care, to be on watch or ensure compliance with medication regimens, as long as the patient has been provided an opportunity to agree or object to the disclosure and no objection has been made.

We may also use or disclose your health information if we believe that the use or disclosure is necessary for law enforcement authorities to identify or apprehend an individual who: (i) admits to participation in a violent crime that we reasonably believe caused serious physical harm to the victim, (ii) appears to have escaped from a correctional institution or lawful custody, or (iii) to the extent State law require providers to make certain disclosures.

Notification and Disaster Relief. We may use or disclose your health information to notify or assist in notifying your family, a personal representative, or another person responsible for your care, of your location, condition, or death. We may disclose your health information to disaster relief authorities so that your family can be notified of your location and condition.

Decedents. Health information may be disclosed to funeral directors, medical examiners or coroners to enable them to carry out their lawful duties. Once you have been dead for 50 years (or such other period as may be specified by law), we may use and disclose your health information without regard to the restrictions set forth in this Notice.

Government Functions. We may disclose your health information for specialized government functions, such as military and veteran’s activities, national security and intelligence activities, and protection of public officials.

Coroners, Medical Examiners and Funeral Directors. To a coroner or medical examiner, (as necessary, for example, to identify a deceased person or determine the cause of death) or to a funeral director, as necessary to allow him/her to carry out his/her activities.

Organ and Tissue Donation. If you are an organ or tissue donor, to organizations that handle organ procurement or organ, eye or tissue transplantation, or to an organ donation bank, as necessary to facilitate a donation and transplantation.

Workers’ Compensation. Your health information may be used or disclosed to comply with laws and regulations related to Workers’ Compensation. For workers’ compensation or similar work-related injury programs, to the extent required by law.

Lawsuits and Disputes. In response to a subpoena or a court or administrative order, if you are involved in a lawsuit or a dispute, or in response to a court order, subpoena, warrant, summons or similar process, if asked to do so by law enforcement.

Military and Veterans. As required by military command or other government authority for information about a member of the domestic or foreign armed forces, if you are a member of the armed forces.

National Security; Intelligence Activities; Protective Service. To federal officials for intelligence, counterintelligence, and other national security activities authorized by law, including activities related to the protection of the President, other authorized persons or foreign heads of state, or related to the conduct of special investigations.

Inmates. To a correctional institution (if you are an inmate) or a law enforcement official (if you are in that official’s custody) as necessary (i) for the institution to provide you with health care; (ii) to protect your or others’ health and safety; or (iii) for the safety and security of the correctional institution.

Business Associates. We may contract with one or more third parties, our business associates, during our business operations. We may disclose your health information to our business associates so that they can perform the job we have asked them to do. We require that our business associates sign a business associate agreement and agree to safeguard the privacy and security of your health information.

Social Services. AXTUALISED may disclose a patient’s PHI for treatment purposes without having to obtain the patient’s authorization when treatment includes the coordination or management of health care by a health care provider with a third party. Health care means care, services, or supplies related to the health of an individual in which the disclosing provider believe that disclosures to certain social service entities are a necessary component of, or may help further, the individual’s health or mental health care may disclose the minimum necessary PHI to such entities without the individual’s authorization. For example, AXTUALISED may disclose PHI about a patient needing mental health care supportive housing to a service agency that arranges such services for individuals.

AXTUALISED may also disclose PHI to such entities pursuant to a signed authorization. Thus, AXTUALISED could in one authorization identify a broad range of social services entities that may receive the PHI if the individual agrees. For example, an authorization could indicate that PHI will be disclosed to “social services providers” for purposes of “supportive housing, public benefits, counseling, and job readiness.”

Abuse. AXTUALISED may disclose protected health information about an individual whom we reasonably believe to be a victim of abuse, neglect, or domestic violence to a government authority, including a social service or protective services agency, authorized by law to receive such reports.

Emergency. A health care provider, when a patient is not present or is unable to agree or object to a disclosure due to incapacity or emergency circumstances, to determine whether disclosing a patient’s information to the patient’s family, friends, or other persons involved in the patient’s care or payment for care, is in the best interests of the patient.  Where a provider determines that such a disclosure is in the patient’s best interests, the provider would be permitted to disclose only the PHI that is directly relevant to the person’s involvement in the patient’s care or payment for care