NOTICE OF PRIVACY PRACTICES

Effective Date: 1-1-2026

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.

1. OUR LEGAL DUTIES

Advance Psychotherapy Practice, PC (“the Practice”) is required by law to:

  • Maintain the privacy and security of your protected health information (“PHI”).

  • Provide you with this Notice of Privacy Practices.

  • Follow the terms of this Notice currently in effect.

  • Notify you following a breach of unsecured PHI.

We reserve the right to change the terms of this Notice and to make the revised Noticeeffective for all PHI we maintain. Any updated Notice will be available upon request and posted on our website.

Some uses and disclosures of protected health information that are permitted under federal law may be further restricted by Massachusetts law. In those cases, we follow the more protective state requirements.

2. HOW WE MAY USE AND DISCLOSE YOUR PHI WITHOUT AUTHORIZATION

A. Treatment

We may use and disclose your protected health information to provide, coordinate, or manage your mental health care. This includes consultation with other health care providers involved in your treatment, referrals, and coordination of care.

Disclosures for treatment purposes do not require your written authorization under federal law. Some disclosures may be further limited by applicable Massachusetts law.

B. Payment

We may use and disclose your PHI to obtain payment for services provided to you. This includes billing insurance companies, verifying benefits, and collecting payment for services.

C. Health Care Operations

We may use and disclose your PHI for health care operations necessary to operate the Practice and ensure quality care, such as quality assessment, training, audits, licensing, accreditation, and administrative activities.

D. Appointment Reminders and Health-Related Communications

We may contact you to remind you of appointments or to provide information related to your treatment or services.

E. Uses and Disclosures Required or Permitted by Law

We may disclose your PHI when required or permitted by law, including for:

  • Public health and safety activities

  • Reporting abuse, neglect, or domestic violence

  • Health oversight activities

  • Judicial or administrative proceedings

  • Law enforcement purposes

  • Coroners, medical examiners, or funeral directors

  • Workers’ compensation claims

  • To prevent or lessen a serious and imminent threat to health or safety

3. USES AND DISCLOSURES REQUIRING YOUR WRITTEN AUTHORIZATION

We will obtain your written authorization before using or disclosing your PHI for purposes not described in this Notice, including:

  • Psychotherapy notes

  • Marketing communications where the Practice receives payment

  • Sale of PHI

You may revoke an authorization at any time in writing, except to the extent that we have already relied on it.

4. YOUR RIGHTS REGARDING YOUR PHI

You have the right to:

  • Inspect and obtain a copy of your PHI (paper or electronic).

  • Request an amendment to your PHI if you believe it is incorrect or incomplete.

  • Request an accounting of disclosures of your PHI for certain disclosures made within the last six years.

  • Request restrictions on certain uses or disclosures of your PHI (we are not required to agree).

  • Request confidential communications by alternative means or locations.

  • Receive a paper copy of this Notice at any time.

  • Be notified following a breach of unsecured PHI.

5. COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with:

Advance Psychotherapy Practice, PC
Privacy Officer
48 N. Pleasant Street
Amherst, MA 01002
Phone: 413-813-1515
Email: info@advancepsychotherapy.org

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights.

We will not retaliate against you for filing a complaint.

6. CONTACT INFORMATION

If you have questions about this Notice or your privacy rights, please contact:

Privacy Officer
Advance Psychotherapy Practice, PC
48 N. Pleasant Street
Amherst, MA 01002
Phone: 413-813-1515
Email: info@advancepsychotherapy.org

7. ACKNOWLEDGMENT OF RECEIPT

We will make a good-faith effort to obtain your written acknowledgment that you received this Notice of Privacy Practices.