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.

Peak Body & Mind ("Peak Body and Mind," "we," "us," or "our") is committed to protecting the privacy of your health information. We are required by law to maintain the privacy of protected health information, to give you this Notice of our legal duties and privacy practices, to follow the terms of the Notice currently in effect, and to notify you if a breach of your unsecured health information occurs. "Protected health information" (or "health information") means information that identifies you and relates to your past, present, or future health, treatment, or payment for care.

1. How We May Use and Disclose Your Health Information

We may use and disclose your health information for the following purposes without your written authorization:

Treatment. We may use and disclose your health information to provide, coordinate, or manage your care, including consultations with, and referrals to, other providers involved in your treatment.

Payment. Because we are a direct-pay practice, we do not bill insurance for care. We may use and disclose your health information to obtain payment from you, to determine fees, or, if you choose to seek reimbursement from a third party, to provide documentation you request for that purpose.

Health Care Operations. We may use and disclose your health information for the operation of our practice, such as quality assessment and improvement, reviewing the competence of our providers, scheduling, and general administrative activities.

2. Other Uses and Disclosures Permitted or Required Without Your Authorization

In certain circumstances, the law permits or requires us to use or disclose your health information without your authorization, including: when required by federal, state, or local law; for public health activities, such as reporting disease or reactions to medications; to report suspected abuse, neglect, or domestic violence; for health oversight activities authorized by law; in response to a court or administrative order, subpoena, or other lawful process; for specified law enforcement purposes; to coroners, medical examiners, and funeral directors; for organ or tissue donation; for approved research under privacy safeguards; to avert a serious and imminent threat to the health or safety of a person or the public; for specialized government functions, such as military and national security activities; and for workers' compensation as authorized by law.

3. Uses and Disclosures That Require Your Written Authorization

Other uses and disclosures of your health information will be made only with your written authorization. In particular, most uses and disclosures of psychotherapy notes, uses and disclosures for marketing purposes, and any disclosure that constitutes a sale of health information require your written authorization. If you provide an authorization, you may revoke it in writing at any time, and we will stop using or disclosing your information for that purpose, except to the extent we have already relied on it.

4. Special Protections for Mental Health and Substance Use Information

Because we provide psychiatric and mental health care, some of your information may receive additional protection under federal and Nevada law. Records relating to mental health treatment and substance use disorder may be subject to stricter confidentiality rules, and in some cases we may not disclose them without your specific written consent, even for purposes that would otherwise be permitted. Where more than one law applies, we will follow the law that provides you the greater protection.

5. Your Rights Regarding Your Health Information

Access and copies. You have the right to inspect and receive a copy of your health information that we maintain, subject to limited exceptions. We may charge a reasonable, cost-based fee.

Amendment. You have the right to request that we amend health information you believe is incorrect or incomplete. We may deny your request in certain circumstances, and if we do, we will explain why in writing.

Accounting of disclosures. You have the right to receive a list of certain disclosures of your health information that we made, as required by law.

Restrictions. You have the right to request restrictions on how we use or disclose your health information. We are not required to agree to all requests. However, if you pay for a service or item in full, out of pocket, you have the right to request that we not disclose the health information related to that service to a health plan, and we will honor that request except where the law requires otherwise. Because we are a direct-pay practice, this protection applies broadly to the care you receive from us.

Confidential communications. You have the right to request that we communicate with you about your health in a particular way or at a particular location, and we will accommodate reasonable requests.

Paper copy. You have the right to receive a paper copy of this Notice upon request, even if you have agreed to receive it electronically.

Breach notification. You have the right to be notified if a breach of your unsecured health information occurs.

To exercise any of these rights, please contact us using the information in Section 9.

6. Our Responsibilities

We are required to maintain the privacy of your health information, to provide you with this Notice describing our legal duties and privacy practices, to follow the terms of the Notice currently in effect, and to notify you following a breach of unsecured health information. We will not use or disclose your health information other than as described in this Notice unless you authorize us to do so in writing.

7. Changes to This Notice

We reserve the right to change this Notice and to make the revised Notice effective for health information we already have as well as information we receive in the future. The current Notice will be posted in our office and on our website, and the effective date will appear on the first page. You may request a copy of the current Notice at any time.

8. Complaints

If you believe your privacy rights have been violated, you may file a complaint with us using the contact information in Section 9, or with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W., Washington, D.C. 20201
Phone: 1-800-368-1019 (TDD: 1-800-537-7697)
Online: ocrportal.hhs.gov

9. Contact Us

If you have questions about this Notice or wish to exercise any of your rights, please contact our Privacy Officer:

Privacy Officer: Joshua Swigart
Peak Body and Mind
530 Hammill Ln, Reno, NV 89511
Phone: 775-376-1124
Email: peak@peakbodymind.com