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MindSol Psychiatry

Notice of Privacy Practices

MindSol Psychiatry

Effective Date: October 15, 2026

Your Information. Your Rights. Our Responsibilities.

This notice describes how medical information about you may be used and disclosed, how you can access this information, and your rights regarding your health information. Please review it carefully.

This Notice of Privacy Practices applies to protected health information maintained by MindSol Psychiatry and describes your rights, how your health information may be used or disclosed, and MindSol Psychiatry's responsibilities regarding your information.

Your Rights

You have the right to:

  • Obtain an electronic or paper copy of your medical record and other health information maintained about you.

  • Ask us to correct health information you believe is incorrect or incomplete.

  • Request that we communicate with you in a specific way or at a specific location.

  • Ask us to limit certain uses or disclosures of your health information.

  • Request an accounting of certain disclosures of your health information.

  • Obtain a paper or electronic copy of this Notice.

  • Choose an authorized person to act on your behalf.

  • File a complaint if you believe your privacy rights have been violated.

Obtain a Copy of Your Health Information

You may ask to see or receive an electronic or paper copy of your medical record and other health information we maintain about you.

We will generally provide a copy or summary of your health information within 30 days of your request. We may charge a reasonable, cost-based fee as permitted by law.

Ask Us to Correct Your Medical Record

You may ask us to correct health information about you that you believe is incorrect or incomplete.

We may deny your request in certain circumstances, but if we do, we will explain the reason in writing within the timeframe required by law.

Request Confidential Communications

You may ask us to contact you in a specific way, such as at a particular telephone number, or to send communications to a different address.

We will accommodate reasonable requests as required by law.

Ask Us to Limit What We Use or Share

You may ask us not to use or disclose certain health information for treatment, payment, or health care operations. We are not generally required to agree to your request.

If you pay for a health care service in full out of pocket, you may ask us not to disclose information about that service to your health insurer for payment or health care operations. We will honor the request unless disclosure is required by law.

Obtain a List of Certain Disclosures

You may ask for an accounting of certain disclosures of your health information made during the six years before the date of your request.

The accounting will not include certain disclosures, including many disclosures for treatment, payment, and health care operations and certain disclosures that you specifically requested.

One accounting within a 12-month period will be provided without charge. A reasonable, cost-based fee may apply to additional requests during that period.

Obtain a Copy of This Notice

You may request a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.

Choose Someone to Act for You

If another person has legal authority to act on your behalf, such as a legal guardian, health care agent, or other authorized personal representative, that person may exercise your privacy rights as permitted by law.

We will verify the individual's authority when appropriate before taking action.

File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with MindSol Psychiatry using the contact information at the end of this Notice.

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

MindSol Psychiatry will not retaliate against you for filing a complaint or exercising your privacy rights.

Your Choices

For certain health information, you may tell us your preferences about what information we share.

This may include sharing relevant information with family members, close friends, caregivers, or others involved in your care or payment for your care.

If you are unable to communicate your preference, we may share information when permitted by law if we believe doing so is in your best interest. We may also disclose information when necessary and permitted by law to reduce a serious and imminent threat to health or safety.

For certain uses and disclosures, we will obtain your written authorization when required by law.

We will obtain your written authorization before using or disclosing your protected health information for purposes requiring authorization, including certain uses of psychotherapy notes, marketing purposes, or the sale of protected health information, as applicable.

You may generally revoke an authorization in writing at any time. A revocation will not affect actions already taken based on your authorization.

How We Typically Use or Share Your Health Information

Treatment

We may use your health information and share it with other health care professionals involved in your treatment.

For example, we may share relevant information with another health care provider when necessary to coordinate your care.

Health Care Operations

We may use and share your health information to operate the practice, manage your treatment and services, improve the quality of care, conduct compliance activities, and perform other health care operations permitted by law.

Payment

We may use and disclose your health information to bill for services and obtain payment from health plans or other entities.

MindSol Psychiatry uses Headway for certain administrative functions related to scheduling, insurance, and billing. Information may be used or disclosed as permitted by law in connection with these functions.

Other Uses and Disclosures

We may also use or disclose health information when permitted or required by law, including for:

  • Public health and safety activities;

  • Reporting suspected abuse, neglect, or domestic violence when required or permitted by law;

  • Preventing or reducing a serious threat to health or safety;

  • Health oversight activities;

  • Workers' compensation;

  • Certain law enforcement and government requests;

  • Judicial and administrative proceedings;

  • Medical examiners, coroners, and funeral directors;

  • Research when permitted by applicable law; and

  • Other purposes required or permitted by federal or state law.

Additional legal protections may apply to certain categories of information, including mental health information, psychotherapy notes, substance use disorder records, HIV-related information, genetic information, and other specially protected health information.

MindSol Psychiatry will comply with applicable federal and state confidentiality laws when those laws provide additional protection for your health information.

Substance Use Disorder Records

To the extent MindSol Psychiatry creates or maintains substance use disorder patient records that are subject to 42 CFR Part 2, those records receive additional protections under federal law.

Such information will not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you except as permitted by applicable federal law, including with your written consent or an appropriate court order and subpoena when required.

Our Responsibilities

MindSol Psychiatry is required by law to:

  • Maintain the privacy and security of your protected health information.

  • Inform you promptly if a breach occurs that may have compromised the privacy or security of your information, as required by law.

  • Follow the duties and privacy practices described in the Notice currently in effect.

  • Provide you with a copy of this Notice.

  • Obtain your written authorization before using or disclosing your health information when authorization is required by law.

We will not use or disclose your information for purposes other than those described in this Notice unless you authorize us in writing or the use or disclosure is otherwise permitted or required by law.

Changes to This Notice

MindSol Psychiatry may change the terms of this Notice and its privacy practices as permitted by law. Changes may apply to health information we already maintain as well as information received in the future.

If the Notice is revised, the current version will be available upon request and on the MindSol Psychiatry website.

Questions, Requests, or Complaints

If you have questions about this Notice, would like to exercise your privacy rights, or wish to file a complaint with MindSol Psychiatry, please contact:

MindSol Psychiatry
Privacy Contact: Sabrina Palmer
Email: hello@mindsolpsychiatry.com
Phone: 631-646-1253

You may also file a complaint with:

U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
1-877-696-6775

MindSol Psychiatry will not retaliate against you for filing a complaint or exercising your privacy rights.

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