HIPAA notice
Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed, and how you can get access to this information. Please review it carefully.
Effective date: October 1, 2026. This notice applies to Hawthorne Mental Health LLC. A paper copy is available at the practice, or by request using the details in section 10.
1. Our duty to protect your health information
Hawthorne Mental Health LLC, trading as Hawthorne Psychiatry, is required by law to maintain the privacy of protected health information, to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect.
Protected health information means information that identifies you and relates to your physical or mental health, the care provided to you, or payment for that care.
2. Treatment, payment and health care operations
We may use and disclose your health information without your written authorization for the following purposes.
Treatment
To provide, coordinate or manage your care. For example, to consult another clinician involved in your treatment, or to send a prescription to a pharmacy.
Payment
To bill and collect payment for the care provided. For example, to confirm coverage with your health plan or to submit a claim.
Health care operations
For the practice's own administration and quality of care. For example, record keeping, audit, and arranging legal or accounting services.
3. Other uses and disclosures permitted by law
The law permits or requires disclosure without your authorization in a limited set of circumstances, including:
- Where required by federal, state or local law.
- To public health authorities, for activities such as preventing disease.
- To report suspected abuse, neglect or domestic violence, as required.
- For health oversight activities, such as audits and investigations.
- In response to a court order, subpoena or other lawful process.
- To law enforcement in the limited circumstances the law specifies.
- To avert a serious and imminent threat to the health or safety of you or another person.
- For workers' compensation, to the extent the law requires.
- To coroners, medical examiners and funeral directors, as permitted.
- For specialised government functions, including military and veterans activities and national security.
Where you are present and able to agree, we may share information relevant to your care with a family member, friend or other person you identify. Where you are not able to agree, for example in an emergency, we may share what is directly relevant using our professional judgement.
4. Uses and disclosures that need your written authorization
Your written authorization is required for:
- Most uses and disclosures of psychotherapy notes.
- Any use or disclosure for marketing purposes.
- Any sale of protected health information.
- Any other purpose not described in this notice.
You may revoke an authorization in writing at any time. Revoking it stops future use and disclosure under that authorization, but does not undo anything already done in reliance on it.
5. Psychotherapy notes
Psychotherapy notes are kept separate from the rest of your record. With narrow exceptions set out in law, they are not used or disclosed without your specific written authorization, and a health plan may not condition treatment, payment, enrolment or eligibility on you providing one.
6. Your rights
- Inspect and copy. You may inspect and obtain a copy of your health information, including an electronic copy where it is held electronically. A reasonable, cost based fee may apply.
- Amend. You may ask for information you believe is incorrect or incomplete to be amended. If the request is denied, you may file a statement of disagreement, which will be kept with the record.
- An accounting of disclosures. You may ask for a list of certain disclosures made in the six years before your request.
- Request restrictions. You may ask us to restrict how your information is used or disclosed. We are not required to agree, except that we must agree to withhold information from a health plan where you have paid for the service in full yourself and the disclosure is for payment or operations.
- Confidential communications. You may ask to be contacted at a particular address or number, and reasonable requests will be accommodated.
- A paper copy of this notice. You may ask for one at any time, even if you agreed to receive it electronically.
- Choose someone to act for you. A personal representative, such as someone holding a medical power of attorney, may exercise these rights on your behalf.
Requests should be made using the contact details in section 10.
7. Breach notification
If there is a breach of unsecured protected health information about you, you will be notified as the law requires.
8. How to complain
If you believe your privacy rights have been violated, you may complain to the practice using the details in section 10, and you may complain to the Secretary of the United States Department of Health and Human Services, Office for Civil Rights.
You will not be penalised, and your care will not be affected, for making a complaint.
9. Changes to this notice
We may change this notice and apply the revised version to health information we already hold as well as information we receive in future. The current version will be posted on this page and made available at the practice, showing its effective date.
10. Who to contact
Privacy contact, Hawthorne Mental Health LLC
1612 Bonforte Blvd, Pueblo, CO 81001
Telephone (720) 897-6735
Email info@hawthornepsychiatry.com
Please do not include health information in an email. Email is not a secure channel. Call instead, or ask for a form to be sent to you.