Privacy Policy

Practice- Health Insurance Portability and Accountability Act (HIPAA) Required

Address:

500 Westpark Dr. Suite 310 Peachtree City, Ga 30269 

Phone: 770-750-4254

Email: info@nurtureandbe.com

Effective: 4/14/03

Date of Last Revision: 2/16/2026

Health Insurance Portability and Accountability Act (HIPAA) NOTICE OF PRIVACY PRACTICES

I. COMMITMENT TO YOUR PRIVACY: 

Nurture and Be Therapy Services, LLC is dedicated to maintaining the privacy of your protected health information (PHI). PHI includes any information that may identify you and relates to your past, present, or future physical or mental health condition or health care services.

This Notice of Privacy Practices (“Notice”) is required by law to explain the legal duties and privacy practices Nurture and Be Therapy Services, LLC upholds regarding your PHI. It describes how medical and mental health information may be used and disclosed and outlines your rights concerning your PHI. Please read carefully and discuss any questions with your provider.

II. LEGAL DUTY TO SAFEGUARD YOUR PHI: 

By federal and state law, Nurture and Be Therapy Services, LLC must ensure that your PHI remains private. This Notice explains when and why Nurture and Be Therapy Services, LLC may use or disclose your PHI.

• Use of PHI refers to when information is shared, applied, examined, or analyzed within the practice.
• Disclosure refers to when information is released or revealed to a third party outside the practice.

Except in certain circumstances, Nurture and Be Therapy Services, LLC will not use or disclose more PHI than necessary for a given purpose. The practice is legally required to follow the privacy practices described in this Notice.

III. CHANGES TO THIS NOTICE: 

The terms of this Notice apply to all records containing your PHI created or kept by Nurture and Be Therapy Services, LLC. The practice reserves the right to revise or amend this Notice at any time.

Any revision applies to all PHI maintained by Nurture and Be Therapy Services, LLC, past or future. A current version will always be available in the office, and you may request a copy at any time. The most recent revision date is listed at the end of this Notice.

IV. HOW Nurture and Be Therapy Services, LLC MAY USE AND DISCLOSE YOUR PHI: 

Nurture and Be Therapy Services, LLC will not use or disclose your PHI without your written authorization, except as described in this Notice or in the “Information, Authorization and Consent to Treatment” document. Below are categories of potential uses and disclosures with examples.

1. For Treatment

Nurture and Be Therapy Services, LLC may disclose your PHI to physicians, psychiatrists, psychologists, or other licensed healthcare providers involved in your care.

Example: If you are also receiving psychiatric medication management, we may share relevant information to coordinate treatment. Except in emergencies, written authorization is obtained prior to consultation.

2. For Health Care Operations

PHI may be used to support the efficient operation of the practice.

Example: During quality control or compliance reviews, PHI may be shared with office personnel, accountants, consultants, or attorneys. Client names are concealed whenever possible.

3. To Obtain Payment

PHI may be used or disclosed to bill and collect payment for services provided.

Example: PHI may be sent to your insurance company to secure reimbursement.

4. Employees and Business Associates

Business associates who perform contracted services must also safeguard your PHI under a written agreement.

Note: Georgia and federal laws offer additional protections for certain types of sensitive information such as substance use, mental health, and HIV/AIDS.

V. USE AND DISCLOSURE OF YOUR PHI IN CERTAIN SPECIAL CIRCUMSTANCES

Nurture and Be Therapy Services, LLC may use or disclose PHI without your consent or authorization in certain legally required situations:

Law Enforcement

PHI may be disclosed when required by law, court order, or administrative proceeding.

Lawsuits and Disputes

PHI may be disclosed in response to court orders, subpoenas, or arbitration requests, after notifying you when required.

Public Health Risks

PHI may be shared with public health authorities for preventing or controlling disease, reporting vital events, or notifying individuals at risk.

Food and Drug Administration (FDA)

PHI may be disclosed for activities related to product safety, defects, or recalls.

Serious Threat to Health or Safety

PHI may be disclosed if necessary to prevent or lessen a serious and imminent threat.

Minors

Certain information may be disclosed to parents or guardians as allowed by law.

Abuse and Neglect

Nurture and Be Therapy Services, LLC must report suspected abuse or neglect of children, elders, or dependent adults.

Coroners, Medical Examiners, Funeral Directors

PHI may be disclosed as needed to carry out legally authorized duties.

Family, Friends, or Others Involved in Your Care

PHI may be shared with individuals involved in your care or in disaster relief efforts unless you object.

Military and Veterans

PHI may be disclosed as required by military command authorities.

National Security and Intelligence Activities

PHI may be disclosed to authorized federal officials for national security purposes.

Correctional Institutions

If you are incarcerated, PHI may be disclosed for your health or the safety of others.

Research

PHI may be used for research with your written authorization, unless fully de-identified and approved by an institutional review board.

Workers’ Compensation

PHI may be disclosed to comply with workers’ compensation laws.

Appointment Reminders

The practice may contact you to remind you of appointments or inform you of services or benefits.

Health Oversight

PHI may be disclosed to oversight agencies for audits, investigations, or compliance activities.

Other Disclosures Required by Law

VI. OTHER USES AND DISCLOSURES REQUIRE WRITTEN AUTHORIZATION

Any use or disclosure not described in this Notice requires your written authorization. You may revoke your authorization in writing at any time, but this will not affect PHI already disclosed with your permission.

Nurture and Be Therapy Services, LLC must continue to comply with laws requiring certain disclosures and must retain all records of care provided.

VII. RIGHTS YOU HAVE REGARDING YOUR PHI:

Right to Inspect and Copy

You may request to view or obtain copies of your PHI in writing. A response will be provided within 30 days. Certain requests may be denied by law, but you will receive written explanation and information about your right to appeal.

Copy fees may apply (no more than $0.25 per page plus supplies/postage). You may also request a summary if agreed upon in advance.

Right to Request Restrictions

You may request limits on how your PHI is used or disclosed. The practice is not obligated to agree, but if it does, the restriction will be honored except in emergencies.

Right to Request Confidential Communications

You may request PHI be sent to an alternate address or through an alternate method (e.g., email instead of mail), and the practice will accommodate reasonable requests.

Right to an Accounting of Disclosures

You may request a list of disclosures made in the past six years, excluding those related to treatment, payment, operations, or disclosures made with your authorization.

Right to Amend

If you believe your PHI is incorrect or incomplete, you may request an amendment in writing. You will receive a response within 60 days. If denied, you may submit a written statement of disagreement.

Right to Receive This Notice by Email

You may request this Notice electronically or in paper form.

Submit All Written Requests To:

Brooke Ferreira, M.A., LMFT — Director & Privacy Officer

Nurture and Be Therapy Services, LLC

(Addresses listed on page 1)

VIII. COMPLAINTS: 

If you believe your privacy rights have been violated, you may file a complaint with Nurture and Be Therapy Services, LLC or with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be penalized for filing a complaint.

Please discuss any questions or concerns with your provider.

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

I. OUR COMMITMENT TO YOUR PRIVACY

We understand that information about your health is personal and sensitive. We are committed to protecting your privacy and maintaining the confidentiality of your health information.

This Notice describes how we may use and disclose your protected health information (PHI) and your rights under:

• The Health Insurance Portability and Accountability Act (HIPAA), and

• When applicable, federal confidentiality protections for substance use disorder (SUD) treatment records under 42 C.F.R. Part 2.

In some situations, professional ethical standards governing mental health professionals require stricter privacy protections than those required by law. We follow both legal and ethical obligations.

II. OUR LEGAL DUTIES

We are required by law to:

• Maintain the privacy and security of your PHI

• Provide you with this Notice of our legal duties and privacy practices

• Follow the terms of the Notice currently in effect

• Notify you promptly if a breach occurs that may have compromised the privacy or security of your information

III. HOW WE MAY USE AND DISCLOSE YOUR INFORMATION (HIPAA)

Under HIPAA, we may use and disclose your PHI without your written authorization for the following purposes, with the following ethical caveats:

• Treatment: To provide, coordinate, or manage your health care. Unless it is an emergency, we will get a release of information from you in writing before doing so.
• Payment: To bill and collect payment for services, when applicable. For example, we may give information about you to your health insurance plan so it will pay for your services.
• Health Care Operations: For internal administrative activities such as quality assurance, recordkeeping, training, licensing, and compliance.
• Business Associates: We may share PHI with third parties who perform services on our behalf (e.g., our electronic health records platform), but only under written agreements requiring them to safeguard your information and sign a HIPAA Business Associate Agreement.
• Required by Law: We may disclose information when required by federal or state law, court order, or lawful subpoena. However, we will do our best to protect your confidentiality.
• Abuse or Neglect Reporting: We may disclose information when required to report suspected abuse, neglect, or exploitation.
• Serious Threat to Health or Safety: We may disclose information when necessary to prevent or lessen a serious and imminent threat to your health or safety or the safety of others.
• Health Oversight: We may disclose information to health oversight agencies for audits, investigations, licensure, or regulatory activities.

When we use or disclose information, we make reasonable efforts to limit it to the minimum necessary to accomplish the intended purpose, consistent with law and professional ethics.

IV. SPECIAL CONFIDENTIALITY FOR SUBSTANCE USE DISORDER (SUD) RECORDS

(42 C.F.R. Part 2)

If we provide diagnosis, treatment, or referral for treatment of a substance use disorder, certain records may be protected by federal law under 42 C.F.R. Part 2.

• General Rule: Substance use disorder records may not be disclosed without your written consent, even for treatment, payment, or health care operations, unless a specific exception permitted by law applies.
• Consent Requirements: Your written consent must meet specific legal requirements. You may revoke your consent in writing at any time, except to the extent that action has already been taken in reliance on it.
• Redisclosure Prohibition: Federal law prohibits the unauthorized redisclosure of substance use disorder treatment information. Any disclosure made with your consent must include a statement prohibiting further redisclosure unless expressly permitted by law.
• Anti-Discrimination Protections: Federal law prohibits discrimination against individuals based on information related to substance use disorder treatment.
• Emergencies: Limited disclosures may be made without consent in bona fide medical emergencies as permitted by law.

V. PSYCHOTHERAPY NOTES

Psychotherapy notes receive special protection under HIPAA.

We do not disclose psychotherapy notes without your written authorization except in very limited circumstances permitted by law.

Ethical standards may further restrict access to or disclosure of psychotherapy notes beyond what HIPAA allows.

VI. OTHER USES AND DISCLOSURES REQUIRE AUTHORIZATION

Any use or disclosure not described in this Notice requires your written authorization.

You may revoke an authorization at any time in writing, except to the extent that action has already been taken.

We will never sell your information.

We will not use or disclose your information for marketing purposes, as this violates our ethics code.

VII. YOUR RIGHTS

You have the right to:

• Inspect and Obtain Copies: You may inspect and obtain a copy of your PHI in paper or electronic form.
• Obtain This Notice: You may obtain this Notice in paper or electronic form.
• Request Corrections: You may request that we amend your information if you believe it is incorrect or incomplete.
• Request Restrictions: You may request restrictions on certain uses and disclosures. If you pay for a service in full out-of-pocket, you have the right to request that we not disclose information related to that service to your health plan for payment or health care operations.
• Request Confidential Communications: You may request that we communicate with you in a specific way or at a specific location.
• Receive an Accounting of Disclosures: You may request a list of certain disclosures we have made of your information.
• Designate a Personal Representative: You may designate a personal representative to exercise your rights as permitted by law.

VIII. COMPLAINTS

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

You may also file a complaint with:

U.S. Department of Health and Human Services

Office for Civil Rights

You will not be retaliated against for filing a complaint.

IX. CHANGES TO THIS NOTICE

We reserve the right to change this Notice. Changes will apply to all information we maintain. The revised Notice will be available upon request.

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