A Healing Soul, Ltd.

Susan L. Atchison

Notice of Privacy Practices

A HIPAA inspired form

Your information. Your rights. Our responsibilities.

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

Please review it carefully.

 

Your choices

For certain health information, you can tell us your choices about what we share.

If you have a clear preference for how we share your information in the situations described below, talk to us.

Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

· Share information with your family, close friends, or others involved in your care

· Share information in a disaster relief situation

· Include your information in a hospital directory (Note: this item is in the official Office of Civil Rights document, but does not apply to A Healing Soul, Ltd. or your information as we are not affiliated with any hospital.)

· If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

· Marketing purposes

· Sale of your information (A Healing Soul, Ltd. does not sell client information of any kind. Period.)

· Most sharing of psychotherapy notes

In the case of fundraising:

· We may contact you for fundraising efforts, but you can tell us not to contact you again.