NOTICE OF HIPAA PRACTICES

Your Rights

• You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
• We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

• You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
  We may say “no” to your request, but we’ll tell you why in writing within 60 days.

• You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
• We will say “yes” to all reasonable requests.

• You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

• We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
• We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

• You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action.

• You can complain if you feel we have violated your rights by contacting Dr. Daniel Selling at drselling@williamsburgtherapygroup.com or at (347) 765-0904.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
• We will not retaliate against you for filing a complaint.

Your Choices

• 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

• Sale of your information
• Most sharing of psychotherapy notes

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

Our Uses and Disclosures

• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat of harm by you to yourself or to anyone else.

• For workers’ compensation claims
  For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services.

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

NOTICE OF WEBSITE PRIVACY POLICY

• On this Website.
• In email, text, and other electronic messages between you and this Website.
• When you interact with our advertising on third-party websites and services, if that advertising includes links to this policy.

• Any information We collect offline or through any other means;
• Any information collected by any third party, including through any application or content that may link to or be accessible from or on this Website;
• Any information covered by our HIPAA Notice of Privacy Practices.

• Details of your visits to this Website, including traffic data, location data, logs, and other communication data.
• Information about your computer and internet connection, including your IP address, operating system, and browser type.
• We also use automatic data collection from any third party websites on which WGT advertises.

• To present our Website and its contents to you.
• To provide you with information or services that you request from us.
• To fulfill any other purpose for which you provide it.
• To notify you about changes to our Website or any services we offer or provide though it.
• In any other way we may describe when you provide the information.
• For any other purpose with your consent.

• To fulfill the purpose for which you provide it.
• For any other purpose disclosed by us when you provide the information.
• With your consent.

• Tracking Technologies and Advertising. You can set your browser to refuse all or some browser cookies, or to alert you when cookies are being sent If you disable or refuse cookies, please note that some parts of this site may then be inaccessible or not function properly.
• Emails from WTG. If you do not want us to email you our newsletter or about other services we provide, please opt out by unsubscribing to our emails. Each email we sent you provides you with the opportunity to opt out of future emails.