Terms & Conditions

Notice of Privacy Practices

Effective Date: 7/1/2025

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.

Our Commitment to Your Privacy

Registered Professional Nursing and Psychology Services for Human Encouragement, LLC (“Practice,” “we,” “our”) is committed to protecting the privacy of your health information. We are required by law to keep your protected health information (PHI) private, to give you this Notice, and to follow the terms of this Notice.

How We May Use and Disclose Your Health Information

We may use and share your PHI for the following purposes without your written permission:

For Treatment

We may use your health information to provide, coordinate, or manage your care and treatment. For example, we may share information with other healthcare providers involved in your care.

For Payment

We may use and share your health information to bill and receive payment from you, your health plan, or others responsible for payment.

For Healthcare Operations

We may use and share your information for activities necessary to run our practice and ensure you receive quality care, such as staff training, quality assessment, or licensing.

Other Uses and Disclosures Permitted or Required by Law

We may also use or share your information without your written authorization in certain situations, such as:

  • Public health activities (e.g., reporting communicable diseases)

  • Reporting abuse, neglect, or domestic violence

  • Health oversight activities (e.g., audits, investigations)

  • Judicial and administrative proceedings

  • Law enforcement purposes

  • Coroners, medical examiners, and funeral directors

  • Organ and tissue donation

  • Research (under strict oversight)

  • To avert a serious threat to health or safety

  • Specialized government functions (e.g., military, national security)

  • Workers’ compensation claims

  • As required by other federal, state, or local laws

Uses and Disclosures That Require Your Written Authorization

In all other situations, we will ask for your written authorization before using or sharing your information. You may revoke your authorization in writing at any time, except to the extent we have already acted on it.

Examples of situations requiring authorization include:

  • Most uses and disclosures of psychotherapy notes

  • Marketing communications

  • Sale of your PHI

Your Rights Regarding Your Health Information

You have the following rights:

  • Right to Inspect and Copy – You may see or get a copy of your PHI in most cases. We may charge a reasonable fee for copies.

  • Right to Request Amendment – If you believe your records are incorrect or incomplete, you may ask us to correct them.

  • Right to an Accounting of Disclosures – You may request a list of certain disclosures we have made of your PHI.

  • Right to Request Restrictions – You may ask us not to use or share certain information for treatment, payment, or operations. We are not required to agree, except when you request to restrict disclosure to a health plan for services paid out-of-pocket in full.

  • Right to Request Confidential Communications – You may ask us to contact you in a specific way (e.g., at work, by mail) to protect your privacy.

  • Right to a Paper Copy of This Notice – You can request a paper copy of this Notice at any time, even if you agreed to receive it electronically.

To exercise these rights, submit your request in writing to the Privacy Officer listed below.

Our Duties

  • We are required by law to maintain the privacy and security of your PHI.

  • We must provide you with this Notice and follow its terms.

  • We will notify you promptly if a breach occurs that may have compromised the privacy or security of your PHI.

  • We will not use or share your PHI other than as described here unless you give us written permission.

Changes to This Notice

We reserve the right to change the terms of this Notice at any time. Any changes will apply to all PHI we have about you and will be available in our office and on our website.

Questions or Complaints

If you have questions about this Notice or believe your privacy rights have been violated, contact:

Privacy Officer
 Grace Harlow Klein, NP, PhD
Registered Professional Nursing and Psychology Services for Human Encouragement, LLC
15 Arnold Park
Rochester, NY 14607
Phone: 585-473-2733
Email: grace@graceharlowklein.com

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights:

  • Online: https://www.hhs.gov/ocr/privacy/hipaa/complaints/

  • Mail: U.S. Department of Health & Human Services, 200 Independence Avenue, S.W., Washington, D.C. 20201

  • Phone: 1-877-696-6775

You will not be retaliated against for filing a complaint.

Registered Professional Nursing and Psychology Services for Human Encouragement, LLC
 Center for Human Encouragement © 2025