PRIVACY POLICY AND TERMS & CONDITIONS

Terms and Conditions/Privacy Policy

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION 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 health information about you. We create a record of the care and services you receive
from us. We 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 mental health care
practice.
This notice explains how we may use and disclose health information about you. We also describe your
rights regarding the health information we keep about you and certain obligations we have under the
law.

We are required by law to:

Ensure that protected health information (PHI) that identifies you is kept private.
Provide you with this notice of our legal duties and privacy practices regarding your health information.
Follow the terms of the notice currently in effect.
Update this notice when necessary; revised versions will be made available in our office and on our website.

II. HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:
For Treatment, Payment, or Health Care Operations:
Federal privacy rules allow health care providers with a direct treatment relationship with you to use or
disclose your PHI without written authorization for treatment, payment, or operations. For example, if
your clinician consults with another provider about your case, this may involve sharing relevant PHI.
Disclosures for treatment purposes are not limited to the “minimum necessary” standard because full
information may be necessary to provide appropriate care.
Lawsuits and Disputes:

If you are involved in a lawsuit or legal dispute, we may disclose PHI in response to a court or
administrative order, subpoena, or lawful process, provided attempts are made to notify you or protect
the information.

III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:
1. Psychotherapy Notes: We keep psychotherapy notes as defined in 45 CFR § 164.501. Any use or
disclosure of such notes requires your written authorization, except in specific, limited situations
(e.g., treatment, training, legal defense, investigations, safety threats, etc.).
2. Marketing Purposes: We do not use or disclose your PHI for marketing purposes.
3. Sale of PHI: We do not sell your PHI in the regular course of our business.

IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION:
We may use or disclose your PHI without authorization in the following circumstances:

When required by federal or state law
To report abuse or threats to health/safety
For health oversight or audit purposes
For judicial and administrative proceedings
To law enforcement (e.g., crimes on our premises)
To coroners or medical examiners
For research (with proper safeguards)
For military or national security functions
To comply with workers and compensation laws
To send appointment reminders and health-related service information

V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT:
We may share your PHI with family members, friends, or others involved in your care or payment unless
you object. In emergencies, this may happen retroactively.

VI. YOU HAVE THE FOLLOWING RIGHTS REGARDING YOUR PHI:

1. Request Limits on Use/Disclosure: You may request limits on use or disclosure of PHI for
treatment, payment, or operations. We are not required to agree.
2. Restrictions for Self-Pay: If you paid out-of-pocket in full, you may request that information
related to that care not be shared with your health plan.
3. Request Confidential Communications: You can request to be contacted at specific locations
(e.g., home or work) or by certain methods (e.g., phone, mail).
4. Access Your Records: You may request access to your PHI (excluding psychotherapy notes) in
electronic or paper form. We will respond within 30 days and may charge a reasonable fee.
5. Get a List of Disclosures: You may request a list of PHI disclosures (excluding those for
treatment, payment, or operations). One request per year is free; additional requests may incur
a fee.
6. Request Corrections: If you believe your PHI is incorrect or incomplete, you can request an
amendment. We may deny the request but will provide an explanation.
7. Receive a Copy of This Notice: You can receive this notice electronically or on paper, even if you
previously agreed to receive it via email.

VII. SMS MESSAGING – PRIVACY POLICY & TERMS OF USE
By opting in through our website, online booking form, intake paperwork, or by texting a keyword to our
SMS number, you consent to receive SMS messages from The Healing Fountain.
These messages may include:

Appointment reminders
Limited-time promotions (related only to our services)
Client support (scheduling, canceling, confirming appointments)

SMS Terms:

Message Frequency: Recurring; varies (typically up to 4 messages/month)
Message & Data; Data Rates May Apply: Your mobile carrier may charge for text messages sent or received.
Opt-In: Text Opt-In to subscribe to receive follow up messages regarding our website contact page, online booking system, keyword texting opt-in.
Updates: Customer care follow ups, marketing, and office closures.
Opt-Out: Text STOP to unsubscribe. You may also email info@healingfountain.net or call 757-486-1807. You’ll receive a confirmation message, and we’ll remove your number within 24 hours.
Help: Text HELP for assistance. You’ll receive our phone number, email, and website information.

Data Use & Protection:

Data Collection: We collect your name, email, address, and mobile number when you sign up for SMS (via web form, rental agreement, or third-party booking platform).
Data Usage: We use your data only to provide updates, reminders, and relevant info about Healing Fountain’s services.
Data Security: Your data is stored securely with safeguards to prevent unauthorized access.
Data Retention: We will retain your contact info as long as you are subscribed. You may request deletion at any time.
No Data Sharing: We do not sell, rent, or share your personal or mobile data with third parties for marketing or promotional purposes.
Contact Information for Consumers: If you have any questions or concerns about your data or this policy, please contact us at admin@healingfountain.net or 757-486-1807.
Data Transfer Restrictions: We do not transfer your personal or mobile data to any external organizations under any circumstances, even with your authorization or consent.