HIPAA Form

NOTICE OF PRIVACY PRACTICES

Effective July 1, 2023

Our Commitment to Your Privacy

STREST is dedicated to maintaining the privacy of your personal health information (PHI) as part of providing professional services. STREST may allow clients to inspect PHI in person. STREST will provide access to PHI within a fifteen-day period, if deemed legal, otherwise the period will remain within thirty days.

We are required by law to keep this “protected health information” confidential. This notice describes how we use and safeguard your information.

We will use protected health information to provide quality services. If we want to use or disclose your information for another purpose, such as the coordination of care with your doctor, we will discuss this with you and ask you to sign an Authorization to Release Information Form,which allows us to do this.

In some legal situations we may be required to use or share your health information without prior authorization, such as:

  • When there is a serious threat to the health and safety of you, another individual,or the public.
  • Some lawsuits and legal or court proceedings.
  • If required by a law enforcement official.
  • For Workers Compensation and similar benefit programs.

Your Rights Regarding Your Health Information

1.    You have the right to ask us to communicate with you about your health and related issues in a particular way that is more private for you. For example, you can ask us to call your home, not work, to schedule or cancel an appointment.

2.   You have the right to ask us to limit what we tell family members and friends who are involved in your care, or the payment of your care. If we believe there are clinical or legal reasons why we cannot honor your request,we will discuss this with you.

3.   You have the right to look at the health information we have about you. This includes identifying information but does not include session notations. If you wish to view your personal health information, please contact us.

4.   If you believe the information in your records is incorrect or missing important information, you have the right to ask us to make amendments to your health information. You must place this request in writing and include the reasons you would like the changes made.

5.   You have the right to receive an accounting of any disclosures of your protected health information we have made since this notice went into effect.

6.   You have the right to a copy of our current privacy practices.

7.   You have the right to file a complaint if you believe your privacy rights have been violated. You can file a written complaint to STREST. Filing a complaint will not change the care nor services we provide to you in any way.

Acknowledgement of Privacy Practices

Ackknowlege *
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