Patient Privacy Policy

Trust is the foundation of successful therapy. At Hendricks Therapy, we follow strict guidelines to preserve your confidentiality rights. Our Notice of Privacy Practices is available on our website and upon request at each office. This Notice provides specific information on how your health information will be used by our staff.

An Authorization For Release of Mental Health Records requires your written consent for any disclosure of information by our staff to other persons, organizations, or agencies, except in the rare cases of court orders, child abuse, life-threatening situations, and national security issues. This form may also be used to request records from other providers, organizations, or agencies.

While fax remains the primary way for sending secure information, we cannot guarantee confidentiality or security at the receiving end. If you provide a fax number, please ensure that the recipient will ensure the confidentiality of your personal health information.

Email is becoming increasingly common, and your therapist may communicate with you outside of an appointment. Hendricks Therapy takes precautions to ensure that any email communications are kept private within our practice. However, email is not a secure or confidential form of communication with an email f, so please use your discretion in sharing personal information by email. If you receive a response by email, then such information should not be forwarded to others and should be considered specific to your private use.

Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION, PLEASE REVIEW THIS NOTICE CAREFULLY

Your medical record may contain personal information about your health. This information may identify you and relate to your past, present or future physical or mental health condition and related health care services and is called Protected Health Information (PHI). This Notice of Privacy Practices describes how we may use and disclose your PHI in accordance with applicable law. It also describes your rights regarding gaining access to and controlling your PHI. We are required by law to maintain PHI's privacy and provide you with notice of our legal duties and privacy practices with respect to PHI. We are required to abide by the terms of this Notice of Privacy Practices. We reserve the right to change the terms of our Notice of Privacy Practices at any time. Any new Notice of Privacy Practices will be effective for all PHI that we maintain at that time. We will provide you with a copy of the revised Notice of Privacy Practices by posting a copy on our website, sending a copy to you in the mail upon request, or providing one to you at your next appointment.

HOW WE MAY USE AND DISCLOSE HEALTH CARE INFORMATION ABOUT YOU

For Care or Treatment: Your PHI may be used and disclosed to those who are involved in your care for the purpose of providing, coordinating, or managing your services. This includes consultation with clinical supervisors or other team members. Your authorization is required to disclose PHI to any other care provider not currently involved in your care.

For Payment: Your PHI may be used and disclosed to any parties that are involved in payment for care or treatment. If you pay for your care or treatment completely out of pocket with no use of any insurance, you may restrict the disclosure of your PHI for payment.

For Business Operations: We may use or disclose, as needed, your PHI in order to support our business activities, including, but not limited to,ent activities, employee review activities, quality assessm and licensing. We may also disclose PHI in the course of providing you with appointment reminders or leaving messages on your phone or at your home about questions you asked or test results.

Required by Law: Under the law, we must make disclosures of your PHI available to you upon your request. In addition, we must make disclosures to the Secretary of the Department of Health and Human Services for the purpose of investigating or determining our compliance with the requirements of the Privacy Rule, if so required.

Without Authorization: Applicable law and ethical standards permit us to disclose information about you without your authorization only in a limited number of other situations. Examples of some of the types of uses and disclosures that may be made without your authorization are those that are:

  • Required by Law, such as the mandatory reporting of child abuse or neglect or mandatory government agency audits or investigations (such as the health department)

  • Required by Court Order

  • Necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. If information is disclosed to prevent or lessen a serious threat it will be disclosed to the person or persons reasonably able to prevent or lessen the threat, including the target of the threat.

Verbal Permission: We may use or disclose your information to family members that are directly involved in your receipt of services with your verbal permission. We may request a written confirmation for continued disclosure to family members.

With Authorization: Uses and disclosures not specifically permitted by applicable law will be made only with your written authorization, which may be revoked. Your explicit authorization is required to release psychotherapy notes and PHI for the purposes of marketing, subsidized treatment communication and for the sale of such information.

YOUR RIGHTS REGARDING YOUR PHI

You have the following rights regarding PHI we maintain about you. To exercise any of these rights, please submit your request in writing to our Privacy Officer:

  • Right of Access to Inspect and Copy. You have the right, which may be restricted only in exceptional circumstances or with documents released to us, to inspect and copy PHI that may be used to make decisions about the service provided.

  • Right to Amend. If you feel that the PHI we have about you is incorrect or incomplete, you may ask us to amend the information, although we are not required to agree to the amendment.

  • Right to an Accounting of Disclosures. You have the right to request an accounting of certain of the disclosures that we make of your PHI. We may charge you a reasonable fee if you request more than one accounting in any 12-month period.

  • Right to Request Restrictions. You have the right to request a restriction or limitation on the use or disclosure of your PHI for services, payment, or business operations. We are not required to agree to your request.

  • Right to Request Confidential Communication. You have the right to request that we communicate with you about PHI matters in a specific manner (e.g. telephone, email, postal mail, etc.)

  • Right to a Copy of this Notice. You have the right to a copy of this notice.

WEBSITE PRIVACY

Any personal information you provide us with via our website, including your e-mail address, will never be sold or rented to any third party without your express permission. If you provide us with any personal or contact information in order to receive anything from us, we may collect and store that personal data. We do not automatically collect your personal e-mail address simply because you visit our site. In some instances, we may partner with a third party to provide services such as newsletters, surveys to improve our services, health or company updates, and in such cases, we may need to provide your contact information to said third parties. This information, however, will only be provided to these third-party partners specifically for these communications, and the third party will not use your information for any other reason. While we may track the volume of visitors on specific pages of our website and download information from specific pages, these numbers are only used in aggregate and without any personal information. This demographic information may be shared with our partners, but it is not linked to any personal information that can identify you or any visitor to our site.

Our site may contain links to other outside websites. We cannot take responsibility for the privacy policies or practices of these sites, and we encourage you to check the privacy practices of all internet sites you visit. While we make every effort to ensure that all the information provided on our website is correct and accurate, we make no warranty, express or implied, as to the accuracy, completeness, or timeliness of the information available on our site. We are not liable to anyone for any loss, claim, or damages caused, in whole or in part, by any of the information provided on our site. By using our website, you consent to collecting and using personal information as detailed herein. Any changes to this Privacy Policy will be made public on this site so you will know what information we collect and how we use it.

BREACHES

You will be notified immediately if we receive information that there has been a breach involving your PHI.

COMPLAINTS

If you believe we have violated your privacy rights, you have the right to file a complaint in writing with our Privacy Officer at Hendricks Therapy. If you have questions or want additional information, please contact us at (317) 718-8436.

You may request a copy of our current Notice of Privacy Practices by visiting our office and speaking with a member of our staff.

CONTACT US
Call or Text: 317-718-8436
Fax: 317-718-8438
staff@hendrickstherapy.com

*Texting is not secure. Please use caution when sharing personally identifiable information via text.