NOTICE OF PRIVACY PRACTICES
Therapy with Edal | Edalmarys Santos Bradford, LMHC
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU 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. I need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all records of your care generated by this practice.
This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you, and describe certain obligations I have regarding the use and disclosure of your health information.
I am required by law to:
Maintain the privacy of your protected health information (PHI)
Give you this notice of my legal duties and privacy practices
Follow the terms of the notice currently in effect
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, on my website at therapywithedal.com, and through your secure client portal.
Telehealth & Electronic Privacy: All sessions are conducted via Sessions Health, a HIPAA-secure and encrypted telehealth platform. Electronic communications between us are protected in accordance with HIPAA standards. I will never conduct sessions via non-secure platforms such as standard FaceTime, regular phone video, or unencrypted messaging applications.
II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
The following categories describe different ways that I use and disclose health information. For each category I will explain what I mean and provide examples where applicable. Not every use or disclosure in a category will be listed. However, all of the ways I am permitted to use and disclose information will fall within one of the categories.
For Treatment, Payment, or Health Care Operations: Federal privacy rules allow health care providers who have a direct treatment relationship with the patient to use or disclose the patient's personal health information without written authorization to carry out treatment, payment, or health care operations. For example, if I were to consult with another licensed health care provider about your condition, I would be permitted to use and disclose your personal health information, which is otherwise confidential, in order to assist in diagnosis and treatment of your mental health condition.
Disclosures for treatment purposes are not limited to the minimum necessary standard because therapists and other health care providers need access to the full record in order to provide quality care. The word "treatment" includes, among other things, the coordination and management of health care with a third party, consultations between health care providers, and referrals from one health care provider to another.
Lawsuits and Disputes: If you are involved in a lawsuit, I may disclose health information in response to a court or administrative order. I may also disclose health information in response to a subpoena, discovery request, or other lawful process, but only if efforts have been made to inform you about the request or to obtain an order protecting the information requested.
III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION
Psychotherapy Notes: I keep psychotherapy notes as defined in 45 CFR § 164.501. Any use or disclosure of such notes requires your written authorization unless the use or disclosure is:
a. For my use in treating you b. For my use in training or supervising mental health practitioners c. For my use in defending myself in legal proceedings instituted by you d. For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA e. Required by law and limited to the requirements of such law f. Required by law for certain health oversight activities g. Required by a coroner performing duties authorized by law h. Required to help avert a serious threat to the health and safety of others
Marketing Purposes: I will not use or disclose your PHI for marketing purposes.
Sale of PHI: I will not sell your PHI in the regular course of business.
IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION
Subject to certain limitations in the law, I can use and disclose your PHI without your authorization for the following reasons:
Required by Law: When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.
Public Health Activities: For public health activities, including reporting suspected child abuse, elder abuse, or vulnerable adult abuse as required under Florida law, or preventing or reducing a serious and imminent threat to anyone's health or safety.
Reproductive Health Care: In accordance with federal law (45 CFR § 164.502), I will not disclose your PHI to investigate or impose liability related to seeking, obtaining, or providing legal reproductive health care.
Substance Use Disorder Records: If you are receiving treatment for substance use, your records may be protected by additional federal confidentiality regulations under 42 CFR Part 2. These regulations provide extra protections beyond standard HIPAA requirements. In general, I may not disclose that you are receiving substance use treatment or share any related records without your written consent, except in very limited circumstances such as a medical emergency or as required by a court order. I will discuss these protections with you in more detail if they apply to your care.
Health Oversight Activities: For health oversight activities, including audits and investigations by government agencies responsible for overseeing the health care system.
Judicial and Administrative Proceedings: For judicial and administrative proceedings, including responding to a court or administrative order. My preference is to obtain your authorization before doing so whenever possible.
Law Enforcement: For law enforcement purposes as required by law.
Coroners and Medical Examiners: To coroners or medical examiners when performing duties authorized by law.
Research: For research purposes, with appropriate protections in place and as permitted by law.
Specialized Government Functions: For specialized government functions as required by law, including ensuring the proper execution of military missions, protecting the President of the United States, conducting intelligence or counter-intelligence operations, or helping to ensure the safety of those working within or housed in correctional institutions.
Workers' Compensation: For workers' compensation purposes as required by law. My preference is to obtain your authorization before doing so whenever possible.
Appointment Reminders and Health Related Benefits: I may use and disclose your PHI to contact you to remind you that you have an appointment with me. I may also use and disclose your PHI to tell you about treatment alternatives or other health care services or benefits that I offer.
V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT
Disclosures to Family, Friends, or Others: I may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.
VI. YOUR RIGHTS WITH RESPECT TO YOUR PHI
The Right to Request Limits on Uses and Disclosures: You have the right to ask me not to use or disclose certain PHI for treatment, payment, or health care operations purposes. I am not required to agree to your request, and I may say no if I believe it would affect your health care.
The Right to Request Restrictions for Out-of-Pocket Expenses Paid in Full: You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or service that you have paid for out-of-pocket in full.
The Right to Choose How I Send PHI to You: You have the right to ask me to contact you in a specific way or to send information to a different address, and I will agree to all reasonable requests.
The Right to See and Get Copies of Your PHI: Other than psychotherapy notes, you have the right to get an electronic or paper copy of your records and other information that I have about you. I will provide you with a copy of your record, or a summary of it if you agree to receive a summary, within 30 days of receiving your written request. I may charge a reasonable cost-based fee for doing so.
The Right to Get a List of Disclosures I Have Made: You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided authorization. I will respond to your request within 60 days. The list will include disclosures made in the last six years unless you request a shorter time. I will provide the list at no charge, but if you make more than one request in the same year, I may charge a reasonable cost-based fee for each additional request.
The Right to Correct or Update Your PHI: If you believe there is a mistake in your PHI or that important information is missing, you have the right to request a correction or addition. I may say no to your request, but I will tell you why in writing within 60 days of receiving your request.
The Right to Get a Paper or Electronic Copy of This Notice: You have the right to get a paper copy of this Notice at any time, and you have the right to receive a copy by email. Even if you have agreed to receive this Notice electronically, you may request a paper copy at any time.
The Right to File a Complaint: You have the right to file a complaint if you believe your privacy rights have been violated. You may file a complaint with me directly or with the U.S. Department of Health and Human Services Office for Civil Rights. You will not be penalized, retaliated against, or receive any reduction in the quality of your care for filing a complaint.
VII. WEBSITE NOTICE
This Notice of Privacy Practices is posted on my website at therapywithedal.com. If the terms of this Notice change, the updated Notice will be posted on my website and made available through your secure client portal.
VIII. CONTACT INFORMATION
For questions about this Notice or your privacy rights, please contact:
Edalmarys Santos Bradford, LMHC Email: Edal@therapywithedal.com Phone: (813) 364-4953 Website:therapywithedal.com
To File a HIPAA Complaint: U.S. Department of Health & Human Services — Office for Civil Rights Website: hhs.gov/ocr Phone: 1-800-368-1019
You will not be penalized or retaliated against for filing a complaint.
To File a Complaint with the Florida Board: Florida Board of Clinical Social Work, Marriage & Family Therapy, and Mental Health Counseling Email: MQA.491@flhealth.gov Phone: (850) 488-0595 Website:flhealthsource.gov