Guidon Group Behavioral Health LLC

HIPAA Notice of Privacy Practices

Effective Date: March 1, 2026

I. Our Pledge Regarding Health Information
II. How We May Use and Disclose Health Information About You
III. Uses and Disclosures That Require Your Authorization
IV. Uses and Disclosures That Do Not Require Your Authorization
V. Uses and Disclosures Requiring an Opportunity to Object
VI. Your Rights Regarding Your PHI

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

I. OUR PLEDGE REGARDING HEALTH INFORMATION

Guidon Group Behavioral Health LLC (“GGBH”) understands that your health information is personal. We are committed to protecting the privacy of your protected health information (“PHI”). We create and maintain records of the care and services you receive from us. These records are necessary to provide you with quality care and to comply with legal requirements.

This Notice applies to all records of your care generated by our practice. It explains how we may use and disclose your health information, your rights regarding that information, and our legal obligations.

We are required by law to:

Ensure that PHI identifying you is kept private.
Provide you with this Notice of our legal duties and privacy practices.
Follow the terms of the Notice currently in effect.

We may change the terms of this Notice at any time. Any changes will apply to all information we maintain. The updated Notice will be available upon request and on our website.

II. HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU

The categories below describe different ways we may use or disclose your PHI. Not every use or disclosure is listed, but all permitted uses fall within these categories.

For Treatment, Payment, or Health Care Operations

Federal privacy regulations allow health care providers with a direct treatment relationship to use or disclose PHI without written authorization for treatment, payment, and health care operations.

For example, if a clinician consults with another licensed provider about your condition, we may use or disclose your PHI to support diagnosis or treatment.

Disclosures for treatment purposes are not subject to the “minimum necessary” standard because providers require full information to deliver quality care. “Treatment” includes coordination of care, consultations, and referrals.

Lawsuits and Disputes

If you are involved in a lawsuit or legal proceeding, we may disclose PHI in response to a court or administrative order. We may also disclose PHI in response to a subpoena or lawful request, provided reasonable efforts have been made to notify you or obtain protective measures.

III. USES AND DISCLOSURES THAT REQUIRE YOUR AUTHORIZATION

Psychotherapy Notes

We maintain psychotherapy notes as defined in 45 CFR § 164.501. Use or disclosure of these notes requires your written authorization except when:

a. Used by GGBH clinicians for your treatment.
b. Used for training or supervising mental health practitioners.
c. Needed for GGBH to defend itself in legal proceedings initiated by you.
d. Required by the Secretary of Health and Human Services to investigate compliance with HIPAA.
e. Required by law, limited to the legal requirement.
f. Required for certain health oversight activities related to the originator of the notes.
g. Required by a coroner performing authorized duties.
h. Necessary to prevent or lessen a serious threat to health or safety.

Marketing Purposes

GGBH will not use or disclose your PHI for marketing purposes.

Sale of PHI

GGBH will not sell your PHI in the regular course of business.

IV. USES AND DISCLOSURES THAT DO NOT REQUIRE YOUR AUTHORIZATION

Subject to legal limitations, we may use or disclose your PHI without authorization for:

Compliance with state or federal law.
Public health activities, including reporting suspected abuse or preventing serious threats to health or safety.
Health oversight activities such as audits or investigations.
Judicial or administrative proceedings (though we prefer to obtain authorization when possible).
Law enforcement purposes, including reporting crimes on our premises.
Coroners or medical examiners performing authorized duties.
Research activities, such as comparing treatment outcomes.
Specialized government functions (e.g., military missions, national security, correctional institutions).
Workers’ compensation compliance.
Appointment reminders and information about treatment alternatives or health-related services offered by GGBH.

V. USES AND DISCLOSURES REQUIRING AN OPPORTUNITY TO OBJECT

Disclosures to Family, Friends, or Others Involved in Your Care

We may disclose PHI to individuals involved in your care or payment for your care unless you object. In emergencies, we may disclose information and give you the opportunity to object afterward.

VI. YOUR RIGHTS REGARDING YOUR PHI

Right to Request Limits on Uses and Disclosures: You may request restrictions on how we use or disclose your PHI for treatment, payment, or operations. We are not required to agree if the restriction would affect your care.
Right to Restrict Disclosures for Fully Self‑Paid Services: If you pay out-of-pocket in full for a service, you may request that we not disclose PHI related to that service to your health plan.
Right to Request Confidential Communications: You may request that we contact you in a specific way (e.g., at a different address or phone number). We will accommodate reasonable requests.
Right to Inspect and Obtain Copies: You may request an electronic or paper copy of your medical record, excluding psychotherapy notes. We will provide it within 30 days of receiving your written request and may charge a reasonable, cost‑based fee.
Right to an Accounting of Disclosures: You may request a list of disclosures made in the past six years, excluding those for treatment, payment, or operations. We will respond within 60 days. The first list is free; additional requests within the same year may incur a fee.
Right to Request Amendments: If you believe your PHI is incorrect or incomplete, you may request an amendment. If we deny the request, we will explain why in writing within 60 days.
Right to a Paper or Electronic Copy of This Notice: You may request a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.