Notice of Privacy Practices

Effective Date: July 2025
Avenues Psychiatry LLC
admin@avenuespsychiatry.com | (918) 332-9809

I. PURPOSE OF THIS NOTICE

This Notice describes how medical information about you may be used and disclosed, and how you can access this information. We are required by law to maintain the privacy and security of your protected health information (PHI) and to provide you with this Notice of our legal duties and privacy practices.

II. OUR LEGAL DUTIES REGARDING YOUR PHI

We must:

Keep your PHI private and secure.
Provide you with this Notice explaining our legal duties and privacy practices.
Notify you if a breach of unsecured PHI occurs.
Follow the terms of this Notice currently in effect.

We reserve the right to change the terms of this Notice. Changes apply to all PHI we maintain. Updates will be posted at our office and on our website.

III. HOW WE MAY USE AND DISCLOSE YOUR PHI

A. Uses and Disclosures That Do Not Require Your Authorization

For Treatment – To provide and coordinate your mental health care.
For Payment – To bill and collect for services rendered.
For Healthcare Operations – For administrative, legal, and quality assurance activities.
Business Associates – With contractors (e.g., billing services) who assist in care and operations.
Appointment Reminders and Related Benefits – To inform you of upcoming appointments or care options.

B. Other Disclosures Not Requiring Consent

As required by law
Court orders or legal proceedings
Law enforcement purposes
To avert serious threat to health/safety
To report abuse or neglect (child, elder, dependent adult)
Coroner, funeral director, organ donation
Public health and oversight agencies
Military, national security, or protective services
Worker’s Compensation
Health research (in limited, approved scenarios)
Disclosures to family or friends involved in your care, unless you object

C. Uses and Disclosures That Require Your Authorization

We will not use or disclose your PHI without written authorization for:

Marketing communications
Sale of PHI
Most uses of psychotherapy notes

You may revoke your authorization in writing at any time.

IV. YOUR RIGHTS REGARDING YOUR PHI

A. Right to Access

You may inspect or receive copies of your PHI. Requests must be in writing. A response will be provided within 30 days. A nominal fee may apply.

B. Right to Amend

You may request corrections to your PHI. Denied requests will be explained in writing, with appeal options.

C. Right to Request Restrictions

You may ask us to restrict certain uses/disclosures. We are not required to agree unless the restriction pertains solely to a healthcare item or service you paid for in full out-of-pocket.

D. Right to Confidential Communications

You may request communication by alternate methods or locations (e.g., work address or secure email).

E. Right to an Accounting of Disclosures

You may request a list of non-routine disclosures of PHI made in the past 6 years. One free request per year; fees apply to additional requests.

F. Right to a Paper or Electronic Copy of This Notice

You may request this Notice via email or hard copy.

G. Right to Direct Transmission of PHI

You may request an electronic copy of your PHI or have it sent to a third party of your choice.

V. PHI AFTER DEATH

We may disclose limited PHI of deceased individuals to those involved in their care or payment, unless inconsistent with known preferences. PHI protection generally ends 50 years after death.

VI. BREACH NOTIFICATION

If a breach of unsecured PHI occurs, we will notify you promptly with details and steps you should take to protect yourself.

VII. COMPLAINTS

You may file a complaint if you believe your rights have been violated.

To file a complaint, contact:
Dr. Seth Migdalski
Avenues Psychiatry LLC
admin@avenuespsychiatry.com | (918) 332-9809

You may also contact the U.S. Department of Health and Human Services:
200 Independence Ave SW, Washington, D.C. 20201
https://www.hhs.gov/hipaa/filing-a-complaint/