Creative Arts Therapy of Rockland • Effective date: October 28, 2026
NOTICE OF PRIVACY PRACTICES. 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. Our Pledge Regarding Health Information
We understand that health information about you and your health care is personal. We are committed to protecting it. We create a record of the care and services you receive so that we can provide quality care and comply with legal requirements. This Notice applies to all records of your care generated by this mental health care practice. We are required by law to keep protected health information private, give you this Notice of our legal duties and privacy practices, notify you of a breach that may compromise the privacy or security of your PHI, and follow the Notice currently in effect. We may change this Notice, and changes will apply to all information we have about you. The updated Notice will be available upon request, in our office, and on our website.
II. How We May Use and Disclose Health Information About You
Federal privacy rules allow providers with a direct treatment relationship to use or disclose personal health information without written authorization for treatment, payment, and health care operations. Treatment includes coordination of care, consultations, and referrals. Payment may include sending your diagnosis, dates and types of services, and other necessary information to your health plan. Health care operations may include quality review, clinician training or supervision, billing, accounting, legal, or licensing purposes. We may use or disclose PHI for appointment reminders and to tell you about treatment alternatives or health-related services. In response to lawful proceedings, we may disclose information as permitted by law, subject to the protections available under New York and New Jersey law.
III. Uses and Disclosures Requiring Your Authorization
Psychotherapy notes require authorization except in limited situations permitted by law, including treatment by the author, clinician training or supervision, defense in proceedings brought by you, HIPAA compliance investigation, specified health oversight activities, coroner duties, or to avert a serious threat to health or safety. We will not use or disclose PHI for marketing purposes or sell PHI in the regular course of business. HIV/AIDS-related information receives special protection under New York and New Jersey law. Substance use disorder treatment records protected by federal law are not used or disclosed in legal proceedings without specific consent or a qualifying court order. Other uses and disclosures not described in this Notice require your written authorization, which you may revoke in writing to the extent we have not already acted on it.
IV. Uses and Disclosures That Do Not Require Authorization
Subject to legal limitations, we may use or disclose PHI when required by state or federal law; for public health activities, including reporting suspected abuse or neglect; to prevent or lessen a serious and imminent threat to health or safety; for health oversight activities; for judicial and administrative proceedings; for law enforcement purposes; to coroners or medical examiners; for approved research; for specialized government functions; and for workers’ compensation purposes. These disclosures are limited to what applicable law permits or requires.
V. Disclosures Where You May Object
We may provide PHI to a family member, friend, or other person you identify as involved in your care or payment for care unless you object in whole or in part. In an emergency, we may obtain your opportunity to agree or object afterward.
VI. Your Rights With Respect to PHI
You may request limits on certain uses and disclosures, request restrictions for qualifying out-of-pocket expenses paid in full, choose how we send PHI to you, inspect and receive copies of your record other than psychotherapy notes, request a list of certain disclosures, request corrections or updates, receive notice of a breach of unsecured PHI, obtain a paper or electronic copy of this Notice, and choose a legally authorized representative to act for you. Please make requests in writing. We will respond in the timeframes required by law and may charge only a reasonable, cost-based fee where permitted.
VII. Redisclosure of Your Information
When we disclose PHI as described in this Notice, the recipient may redisclose it and it may no longer be protected by the federal HIPAA Privacy Rule. Some information, including HIV/AIDS-related information and substance use disorder treatment records, has additional protections against redisclosure under state and federal law.
VIII. Questions and Complaints
For questions about this Notice or our privacy practices, contact Patricia Grego, Clinical Director and Privacy Officer, Creative Arts Therapy of Rockland, 275 N. Middletown Road, Suite 1D, Pearl River, NY 10965; Phone: 845-793-2657; Email: administrator@therapeuticartsofrockland.com. You may file a complaint with us using this contact information 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.
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