Notice of Privacy Practices

Your Information. Your Rights. Our Responsibilities.

Effective date: August 21, 2025

This Notice describes how medical information about you may be used and disclosed, how you can access this information, and your rights regarding protected health information.

This Notice applies to Neuroscience Psychiatry & Integrative Wellness PLLC (“Neuroscience Psychiatry”) and healthcare professionals and workforce members acting on its behalf.

Your Rights

You may:

  • Obtain a copy of your medical record

  • Request correction of your medical record

  • Request confidential communications

  • Request restrictions on certain uses or disclosures

  • Receive an accounting of certain disclosures

  • Receive a paper or electronic copy of this Notice

  • Authorize another legally permitted person to act for you

  • File a privacy complaint without retaliation

If you pay in full out of pocket for a healthcare item or service and request that information regarding that item or service not be disclosed to your health plan for payment or healthcare operations, the request will be honored when required by law.

Minor Patients and Personal Representatives

A parent, legal guardian, or other legally authorized person may act as a minor patient's personal representative when permitted by law.

There are circumstances in which a minor may legally consent to certain healthcare services without parental or guardian consent. In those circumstances, applicable law may also affect who may access information related to those services.

Neuroscience Psychiatry will determine access to a minor patient's protected health information according to applicable federal and state law.

How We May Use and Share Information

Protected health information may be used or disclosed as permitted or required by law for:

  • Treatment

    Providing, coordinating, or managing healthcare.

  • Payment

    Submitting claims, determining eligibility, obtaining authorization, coordinating benefits, and receiving payment.

  • Healthcare Operations

    Practice operations, quality improvement, compliance, administrative activities, and related functions.

  • Public Health and Safety

    Legally permitted public-health activities, reporting abuse or neglect, or responding to serious threats to health or safety.

  • Legal Requirements

    Disclosures required by federal or state law.

  • Health Oversight

    Legally authorized audits, investigations, inspections, licensing, or oversight activities.

  • Legal Proceedings and Law Enforcement

    Disclosures permitted or required by applicable law.

  • Workers' Compensation

    Disclosures permitted by applicable law.

  • Medical Examiners, Coroners, and Funeral Directors

    Disclosures permitted by applicable law.

  • Research

    Research uses or disclosures permitted under applicable privacy law.

Substance Use Disorder Records

When Neuroscience Psychiatry creates, receives, or maintains records protected by 42 CFR Part 2, additional federal privacy protections may apply.

Protected Part 2 records will be handled according to applicable federal requirements.

Our Responsibilities

Neuroscience Psychiatry is required to:

  • Maintain the privacy and security of protected health information

  • Follow the privacy practices described in the current Notice

  • Notify patients of qualifying breaches when required

  • Obtain authorization when required by law

Changes

The Notice may be updated periodically.

The current version will remain available on the website and upon request.

Privacy Questions or Complaints

Neuroscience Psychiatry & Integrative Wellness PLLC

200 Union Blvd., Suite 200, Lakewood CO 80228

Phone: (720) 636-9092

Email: [email protected]

Patients may also contact:

U.S. Department of Health and Human Services

Office for Civil Rights

200 Independence Avenue, S.W., Room 509F

Washington, D.C. 20201

Phone: 1-800-368-1019

TDD: 1-800-537-7697

Neuroscience Psychiatry will not retaliate against anyone for filing a good-faith privacy complaint.