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.

Find Your Anchor Counseling Services, LCSW, PLLC (the “Practice”) is committed to protecting your privacy. The Practice is required by federal law to maintain the privacy of Protected Health Information (“PHI”), which is information that identifies or could be used to identify you. The Practice is required to provide you with this Notice of Privacy Practices (this “Notice”), which explains the Practice's legal duties and privacy practices and your rights regarding PHI that we collect and maintain.


YOUR RIGHTS
You have the following rights regarding your health information. To exercise any of these rights, please submit a written request to the Practice at the address noted below.

To inspect and copy PHI.
• You can ask for an electronic or paper copy of PHI. The Practice may charge you a reasonable, cost based fee as permitted by law. The Practice will provide access within 30 days, or notify you if an extension is needed.
• The Practice may deny your request if it believes the disclosure will endanger your life or another person's life. You may have a right to have this decision reviewed.

To amend PHI.
• You can ask to correct PHI you believe is incorrect or incomplete. The Practice may require you to make your request in writing and provide a reason for the request.
• The Practice may deny your request. The Practice will send a written explanation for the denial and allow you to submit a written statement of disagreement.

To request confidential communications.
• You can ask the Practice to contact you in a specific way or at a specific location (for example, by phone, email, or secure telehealth platform). The Practice will say “yes” to all reasonable requests.

To limit what is used or shared.
• You can ask the Practice not to use or share PHI for treatment, payment, or business operations. The Practice is not required to agree if it would affect your care.
• If you pay for a service or health care item out-of-pocket in full, you can request the Practice not to share PHI with your health insurer.
• You can ask for the Practice not to share your PHI with family members or friends by stating the specific restriction requested and to whom you want the restriction to apply.

To obtain a list of those with whom your PHI has been shared.
• You can ask for a list, called an accounting, of the times your health information has been shared in the past six (6) years. You can receive one accounting every 12 months at no charge, but you may be charged a reasonable, cost-based fee if you ask for one more frequently.

To receive a copy of this Notice.
• You can ask for a paper copy of this Notice, even if you agreed to receive the Notice electronically.

To choose someone to act for you.
• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights on your behalf.

To file a complaint if you feel your rights are violated.
• You can file a complaint by contacting the Practice using the following information:
Find Your Anchor Counseling Services, LCSW, PLLC
PO Box 75, Shoreham NY 11786
Ashley Petito, LCSW
631-612-8816
• 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/.
• The Practice will not retaliate against you for filing a complaint.

To opt out of receiving fundraising communications.
• The Practice may contact you for fundraising efforts, but you can ask not to be contacted again. Opting out will not affect your care or benefits.

SENSITIVE HEALTH INFORMATION/REPRODUCTIVE HEALTH

The Practice recognizes that some health information is particularly sensitive, including reproductive health care, pregnancy outcomes, and fertility services. The Practice will protect this information with the same high level of confidentiality as all other health records.

The Practice will not disclose reproductive health information for the purpose of investigating or imposing criminal, civil, or administrative liability on any person for seeking, obtaining, providing, or facilitating lawful reproductive health care.
When required by law, The Practice will obtain a valid HIPAA-compliant attestation before making such disclosures.

OUR USES AND DISCLOSURES
1. Routine Uses and Disclosures of PHI
The Practice is permitted under federal law to use and disclose PHI, without your written authorization, for certain routine uses and disclosures, such as those made for treatment, payment, and the operation of our business. The Practice typically uses or shares your health information in the following ways:

To treat you.
• The Practice can use and share PHI with other professionals who are treating you.
• Example: Your primary care doctor asks about your mental health treatment.

To run the health care operations.
• The Practice can use and share PHI to run the business, improve your care, and contact you. This includes use of secure electronic health records and telehealth platforms.
• Example: The Practice uses PHI to send you appointment reminders if you choose.

To bill for your services.
• The Practice can use and share PHI to bill and get payment from health plans or other entities.
• Example: The Practice gives PHI to your health insurance plan so it will pay for your services.

2. Uses and Disclosures of PHI That May Be Made Without Your Authorization or Opportunity to Object
The Practice may use or disclose PHI without your authorization or an opportunity for you to object, including:

To help with public health and safety issues
• Public health: To prevent the spread of disease, assist in product recalls, and report adverse reactions to medication.
• Required by the Secretary of Health and Human Services: We may be required to disclose your PHI to the Secretary of Health and Human Services to investigate or determine our compliance with the requirements of the final rule on Standards for Privacy of Individually Identifiable Health Information.
• Health oversight: For audits, investigations, and inspections by government agencies that oversee the health care system, government benefit programs, other government regulatory programs, and civil rights laws.
• Serious threat to health or safety: To prevent a serious and imminent threat.
• Abuse or Neglect: To report abuse, neglect, or domestic violence.

To comply with law, law enforcement, or other government requests
• Required by law: If required by federal, state or local law.
• Judicial and administrative proceedings: To respond to a court order, subpoena, or discovery request.
• Law enforcement: For law locate and identify you or disclose information about a victim of a crime.
• Specialized Government Functions: For military or national security concerns, including intelligence, protective services for heads of state, or your security clearance.
• National security and intelligence activities: For intelligence, counterintelligence, protection of the President, other authorized persons or foreign heads of state, for purpose of determining your own security clearance and other national security activities authorized by law.
• Workers' Compensation: To comply with workers' compensation laws or support claims.

To comply with other requests
• Coroners and Funeral Directors: To perform their legally authorized duties.
• Organ Donation: For organ donation or transplantation.
• Research: For research that has been approved by an institutional review board.
• Inmates: The Practice created or received your PHI in the course of providing care.
• Business Associates: To organizations that perform functions, activities or services on our behalf.

3. Uses and Disclosures of PHI That May Be Made With Your Authorization or Opportunity to Object
Unless you object, the Practice may disclose PHI:

To your family, friends, or others if PHI directly relates to that person's involvement in your care.

If it is in your best interest because you are unable to state your preference.

4. Uses and Disclosures of PHI Based Upon Your Written Authorization
The Practice must obtain your written authorization to use and/or disclose PHI for the following purposes:

Marketing, sale of PHI, and psychotherapy notes.

Psychotherapy notes receive special protections under federal law.

You may revoke your authorization, at any time, by contacting the Practice in writing, using the information above. The Practice will not use or share PHI other than as described in Notice unless you give your permission in writing.

SPECIAL PROVISIONS FOR MINORS UNDER 18

In accordance with New York Mental Hygiene Law § 33.21:

• Consent for Mental Health Treatment: Generally, the consent of a parent or guardian is required for outpatient mental health services for minors. However, a minor may consent to such services without parental involvement if:

  • The minor is knowingly and voluntarily seeking such services.

  • The provision of such services is clinically indicated and necessary to the minor's well-being.

  • A parent or guardian is not reasonably available, or requiring parental consent would have a detrimental effect on the course of treatment, or a parent or guardian has refused to give such consent and a physician determines that treatment is necessary and in the best interests of the minor.

• Documentation: The mental health practitioner must document the reasons for these determinations and include them in the minor's clinical record, along with a written statement signed by the minor indicating that they are voluntarily seeking services.

• Notice to Parents or Guardians: As clinically appropriate, notice of the determination may be provided to the parent or guardians

OUR RESPONSIBILITIES
• The Practice is required by law to maintain the privacy and security of PHI.
• The Practice is required to abide by the terms of this Notice currently in effect. Where more stringent state or federal law governs PHI, the Practice will abide by the more stringent law.

• The Practice will maintain reasonable administrative, technical, and physical safeguards in compliance with the New York SHIELD Act.
• The Practice reserves the right to amend Notice. All changes are applicable to PHI collected and maintained by the Practice. Should the Practice make changes, you may obtain a revised Notice by requesting a copy from the Practice, using the information above, or by viewing a copy on the website www.findyouranchorli.com.
• The Practice will inform you if PHI is compromised in a breach. If your unsecured PHI is involved in a breach, the Practice will notify you without unreasonable delay and no later than 60 days, as required by law.

USE OF TELEHEALTH SERVICES

Telehealth services are provided using secure, HIPAA-compliant platforms designed to protect your privacy. Telehealth may involve video, audio, and/or electronic communication.

While safeguards are in place, telehealth carries potential risks, including:

• Interruption or technical failure

• Unauthorized access if you are not in a private location

• Limits to confidentiality if others can overhear your session

You are encouraged to participate in sessions from a private, secure location and to use a secure internet connection.

TELEHEALTH EMERGENCY SITUATIONS

Telehealth may not be appropriate for emergencies. If you are experiencing a mental health emergency, please call 911 or go to your nearest emergency room.

ACKNOWLEDGEMENT

By receiving services, including telehealth services, you acknowledge receipt of this Notice of Privacy Practices.

This Notice is effective on 01/01/2026.