LEGAL

NOTICE OF PRIVACY PRACTICES

Effective Date: October 2026

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

The Human Practice PLLC is committed to protecting the privacy and security of your protected health information (“PHI”). PHI includes information about your health, mental health, treatment, and payment for services that identifies you or could reasonably be used to identify you.

The Human Practice PLLC is required by law to maintain the privacy and security of your PHI, provide you with this Notice of Privacy Practices, and follow the privacy practices described in the notice currently in effect.

YOUR RIGHTS

When it comes to your health information, you have certain rights.

Get an electronic or paper copy of your record

You may ask to see or receive an electronic or paper copy of your health record and other health information maintained about you.

The Human Practice PLLC will generally provide a copy or summary of your health information within the time required by law. A reasonable, cost-based fee may be charged when permitted by law.

Ask to correct your record

You may ask The Human Practice PLLC to correct health information about you that you believe is incorrect or incomplete.

Your request may be denied in certain circumstances permitted by law. If your request is denied, you will receive an explanation in writing within the time required by law.

Request confidential communications

You may ask The Human Practice PLLC to communicate with you in a particular way or at a particular location. For example, you may request to be contacted only at a certain telephone number or email address.

Reasonable requests will be accommodated.

Ask to limit what is used or disclosed

You may ask The Human Practice PLLC not to use or disclose certain health information for treatment, payment, or health care operations. The practice is not always required to agree to your request.

If you pay for a health care service out of pocket in full, you may ask that information about that service not be disclosed to your health plan for payment or health care operations. The Human Practice PLLC will honor that request unless disclosure is required by law.

Receive an accounting of disclosures

You may request a list, or accounting, of certain disclosures of your health information made during the six years prior to your request.

The accounting generally does not include disclosures for treatment, payment, or health care operations or certain other disclosures excluded by law.

You may receive one accounting during a 12-month period without charge. A reasonable, cost-based fee may be charged for additional requests within the same 12-month period.

Receive a 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.

Choose someone to act for you

If another person has legal authority to act on your behalf, such as through a valid health care power of attorney, guardianship, or other legally recognized authority, that person may exercise your privacy rights as permitted by law.

The Human Practice PLLC will verify that person’s authority before allowing the person to act on your behalf.

File a complaint

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

Amber Archambault, LCSW
Privacy Officer
The Human Practice PLLC
Email: hello@thehumanpractice.co

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

You will not be retaliated against for filing a complaint.

YOUR CHOICES

For certain health information, you may tell The Human Practice PLLC your preferences regarding what information is shared.

Where permitted by law, you may communicate your preferences regarding sharing information with family members, close friends, or others involved in your care or payment for your care.

If you are unable to communicate your preference, there are limited circumstances in which information may be disclosed when permitted by applicable law, such as when necessary to lessen a serious and imminent threat to health or safety.

In certain circumstances, your written authorization is required before your health information may be used or disclosed, including:

  • For marketing purposes, except as otherwise permitted by law;

  • For the sale of your protected health information; and

  • For most uses and disclosures of psychotherapy notes, if such notes exist.

The Human Practice PLLC does not currently maintain separate psychotherapy notes as that term is defined under HIPAA. Routine psychotherapy progress notes and other clinical documentation maintained as part of your health record are not the same as HIPAA-defined psychotherapy notes.

HOW YOUR HEALTH INFORMATION MAY BE USED OR DISCLOSED

Federal and Connecticut law govern when your health information may be used or disclosed.

Because The Human Practice PLLC provides psychotherapy services through a Connecticut Licensed Clinical Social Worker, communications and records relating to your evaluation or treatment receive confidentiality protections under Connecticut law.

As a general rule, your communications and treatment records will not be disclosed without your written consent except when disclosure is permitted or required by applicable law.

Treatment

Your health information may be used and, when permitted by applicable law, disclosed to other professionals involved in your diagnosis or treatment when necessary to accomplish the objectives of diagnosis or treatment.

Connecticut law may provide additional protections concerning disclosure of communications and records relating to social work evaluation and treatment.

Health Care Operations

Your health information may be used as necessary to operate the practice, manage your treatment and services, perform administrative functions, maintain records, and comply with legal and professional obligations.

When third-party service providers perform functions involving PHI on behalf of the practice, appropriate privacy protections will be used when required by law.

Payment

Your health information may be used as permitted by law for payment-related activities.

The Human Practice PLLC is a private-pay practice and does not currently bill health insurance directly.

If collection of unpaid fees becomes necessary, disclosures will be limited as required by applicable Connecticut law. Connecticut law imposes specific requirements concerning notice and the information that may be disclosed in connection with collection of fees.

CONNECTICUT CONFIDENTIALITY PROTECTIONS

Connecticut law provides specific confidentiality protections for communications and records relating to evaluation or treatment between a person and a licensed clinical social worker.

Generally, these communications and records will not be disclosed unless you or your authorized representative provides written consent or disclosure is otherwise permitted or required by law.

When written consent is required under applicable Connecticut law, the authorization may need to identify the person or agency receiving the information, the scope of information to be disclosed, the purpose of the disclosure, and the expiration date of the authorization.

There are limited circumstances in which Connecticut law permits disclosure without your consent. Depending on the circumstances and applicable law, these may include:

  • Certain disclosures to individuals involved in your diagnosis or treatment or to facilitate an appropriate treatment referral;

  • Situations involving a substantial risk of imminent physical injury to yourself or another person;

  • Disclosures otherwise mandated by Connecticut law;

  • Certain court-ordered evaluations and judicial proceedings when statutory requirements are met;

  • Certain civil proceedings in which a person’s mental condition has been placed at issue and a court makes the findings required by law; and

  • Limited information associated with collection of unpaid fees, subject to the notice and disclosure limitations imposed by Connecticut law.

Other federal or Connecticut laws may also require or permit disclosure in particular circumstances.

OTHER USES AND DISCLOSURES REQUIRED OR PERMITTED BY LAW

Health information may also be used or disclosed when applicable federal or state law permits or requires it. Depending upon the circumstances and applicable Connecticut confidentiality protections, these situations may include:

Public Health and Safety

Information may be disclosed when permitted or required by law for certain public health or safety purposes, including reporting suspected abuse or neglect and preventing or reducing a serious threat to health or safety.

Health Oversight

Information may be disclosed to authorized health oversight agencies for activities permitted by law.

Compliance with Law

Information may be disclosed when state or federal law requires it, including to the U.S. Department of Health and Human Services when necessary to determine compliance with federal privacy law.

Workers’ Compensation and Government Functions

Information may be used or disclosed when authorized by and consistent with applicable law for workers’ compensation or certain government functions.

Medical Examiners and Funeral Directors

Information may be disclosed to a coroner, medical examiner, or funeral director when permitted by applicable law.

Legal Proceedings

Information may be disclosed in response to legal process only when disclosure is permitted or required by applicable federal and Connecticut law. Connecticut law provides additional confidentiality protections for communications and records involving licensed clinical social workers.

SUBSTANCE USE DISORDER RECORDS

To the extent The Human Practice PLLC receives or maintains substance use disorder patient records that are protected by 42 CFR Part 2, additional federal confidentiality protections may apply.

Part 2-protected records generally may not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you unless you provide written consent or disclosure is authorized by an appropriate court order and subpoena as required by law.

The inclusion of this section does not mean that The Human Practice PLLC provides a specialized substance use disorder treatment program. It describes privacy protections that may apply if the practice receives or maintains records protected by 42 CFR Part 2.

RESEARCH, FUNDRAISING, AND MARKETING

The Human Practice PLLC does not currently use or disclose your PHI for fundraising.

The Human Practice PLLC does not sell your PHI.

Your PHI will not be used or disclosed for marketing when your authorization is required by law unless you provide the required authorization.

The practice does not currently conduct research using client PHI. If that practice changes, any use or disclosure of PHI for research will comply with applicable federal and state law.

ELECTRONIC COMMUNICATIONS AND CLIENT PORTAL

The Human Practice PLLC may use electronic systems, including its electronic health record and secure client portal, to maintain records and communicate with clients.

Reasonable administrative, technical, and physical safeguards are used to protect electronic PHI as required by law.

Clients are encouraged to use designated secure methods of communication for sensitive clinical information when available.

OUR RESPONSIBILITIES

The Human Practice PLLC is required by law to:

  • Maintain the privacy and security of your protected health information;

  • Notify you as required by law if a breach occurs that may have compromised the privacy or security of your information;

  • Follow the duties and privacy practices described in the Notice currently in effect; and

  • Provide you with a copy of this Notice.

Your information will not be used or disclosed other than as described in this Notice unless you authorize the use or disclosure in writing or another use or disclosure is permitted or required by law.

If you provide written authorization, you may revoke that authorization in writing, subject to applicable law and except to the extent action has already been taken in reliance upon it.

CHANGES TO THIS NOTICE

The Human Practice PLLC reserves the right to change the terms of this Notice and to make the revised Notice effective for health information already maintained as well as information received in the future, as permitted by law.

The current Notice will be available upon request and will be made available through the practice’s website and/or other appropriate means.

QUESTIONS OR PRIVACY CONCERNS

For questions about this Notice, your privacy rights, or the privacy practices of The Human Practice PLLC, contact:

Amber Archambault, LCSW
Privacy Officer
The Human Practice PLLC
Email: hello@thehumanpractice.co