Notice of Privacy Practices

Effective Date: April 10, 2026

Our Pledge Regarding Your Health Information

We understand that your health information is personal and private. We are committed to protecting it. We create a record of the care and services you receive at Ascend Mind and Body. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this practice, whether made by our physicians, nurse practitioners, therapists, counselors, or staff.

This notice tells you about the ways we may use and disclose your health information. It also describes your rights and certain obligations we have regarding the use and disclosure of your health information.

We are required by law to:

• Maintain the privacy of your Protected Health Information (PHI).
• Give you this notice of our legal duties and privacy practices regarding your health information.
• Follow the terms of the notice that is currently in effect.
• Notify you following a breach of your unsecured PHI.

How We May Use and Disclose Your Health Information

The following categories describe the ways we may use and disclose your health information without your written authorization:

For Treatment

We may use your health information to provide you with medical treatment or services. For example, your primary care physician may share information about your medications with your psychiatrist within our practice to ensure safe, coordinated care. We may also disclose your health information to other providers involved in your treatment, such as labs, pharmacies, or specialists to whom we refer you.

For Payment

We may use and disclose your health information to bill and collect payment for the services we provide. For example, we may need to give your insurance company information about a service you received so your insurer can pay us or reimburse you. We may also need to provide information to a collections agency if your account becomes delinquent.

For Healthcare Operations

We may use and disclose your health information for activities necessary to run our practice and ensure quality care. These activities include quality improvement, staff training, business planning, credentialing, and compliance audits. For example, we may use your health information to evaluate our providers' performance or to train new staff members.

Appointment Reminders and Health-Related Communications

We may contact you to provide appointment reminders or to inform you about treatment options, alternatives, or health-related benefits and services that may be of interest to you.

Individuals Involved in Your Care

Unless you object, we may disclose your health information to a family member, friend, or other person you identify as being involved in your care or payment for your care. We may also disclose information about you to a disaster relief organization to help notify your family or others involved in your care of your location or condition.

As Required by Law

We will disclose your health information when required to do so by federal, state, or local law. This includes disclosures required by:

• Court orders and subpoenas.
• Public health authorities for disease surveillance, reporting, and prevention.
• The Food and Drug Administration (FDA) regarding products and devices.
• Government agencies authorized to receive reports of abuse, neglect, or domestic violence.
• Health oversight agencies for audits, investigations, and inspections.
• Law enforcement officials in certain limited circumstances.
• Coroners, medical examiners, and funeral directors.
• Organ procurement organizations.
• Workers' compensation programs.
• National security and intelligence activities.
• Military and veterans' affairs, if applicable.

To Avert a Serious Threat

We may use and disclose your health information when necessary to prevent a serious and imminent threat to your health or safety, or to the health or safety of the public or another person.

Uses and Disclosures Requiring Your Written Authorization

We will obtain your written authorization before using or disclosing your PHI for purposes other than those described above. The following uses and disclosures require your written authorization:

• Most uses and disclosures of psychotherapy notes (separate from your general medical record).
• Uses and disclosures of your PHI for marketing purposes.
• Sales of your PHI.
• Other uses and disclosures not described in this notice.

You may revoke your authorization in writing at any time. Revocation will not affect any uses or disclosures that occurred before we received your revocation.

Special Protections for Mental Health and Substance Use Information

Ascend Mind and Body provides psychiatric, psychological, and counseling services. Certain mental health and substance use treatment records receive additional protections under federal and state law, including:

• Psychotherapy notes: Notes recorded by your therapist or counselor during or after a session that are kept separate from your medical record receive heightened protection under HIPAA. We will not use or disclose psychotherapy notes without your written authorization, except in limited circumstances permitted by law.
• Substance use disorder records: If applicable, records relating to substance use disorder treatment are protected by federal regulation (42 CFR Part 2) and may not be disclosed without your specific written consent, except as otherwise permitted by law.
• Florida mental health law: Florida Statutes Chapter 394 (the Baker Act) and Chapter 397 (the Marchman Act) may apply to certain disclosures of mental health and substance use information. We comply with all applicable Florida law regarding these records.

Your Rights Regarding Your Health Information

You have the following rights regarding your health information. To exercise any of these rights, submit a written request to our Privacy Officer at the address above.

Right to Access Your Records

You have the right to inspect and obtain a copy of your health information maintained by our practice, including medical and billing records. We may charge a reasonable, cost-based fee for copies. We will respond to your request within 30 days. In limited circumstances, we may deny your request, but we will explain the reason in writing and inform you of your right to have the denial reviewed.

Right to Request an Amendment

If you believe your health information is incorrect or incomplete, you may request that we amend it. We may deny your request if the information was not created by us, is not part of the records we maintain, or is accurate and complete. If we deny your request, we will provide you with a written explanation and your right to submit a statement of disagreement.

Right to an Accounting of Disclosures

You have the right to request a list of certain disclosures of your health information that we made. This accounting does not include disclosures made for treatment, payment, healthcare operations, disclosures you authorized in writing, or certain other disclosures. We will provide one accounting per 12-month period at no charge. Additional requests within the same period may incur a fee.

Right to Request Restrictions

You have the right to request that we restrict how we use or disclose your health information for treatment, payment, or healthcare operations. We are not required to agree to your request, except in one case: if you pay for a service entirely out of pocket and request that we not disclose information about that service to your health plan, we must honor that request.

Right to Request Confidential Communications

You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you may ask us to contact you only at a specific phone number or to send correspondence to a different address. We will accommodate all reasonable requests.

Right to a Paper Copy of This Notice

You have the right to a paper copy of this notice, even if you have agreed to receive it electronically. You may request a paper copy at any time by contacting our office.

Right to Be Notified of a Breach

You have the right to be notified if a breach of your unsecured PHI occurs. We will notify you in writing within 60 days of discovering the breach, as required by HIPAA and the Florida Information Protection Act (FIPA).

Our Duties

• We are required by law to maintain the privacy and security of your PHI.
• We will notify you promptly if a breach occurs that may have compromised the privacy or security of your PHI.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or disclose your PHI without your written authorization, except as described in this notice or as otherwise permitted by law.

Changes to This Notice

We reserve the right to change the terms of this notice and to make the revised notice effective for all PHI we already maintain as well as PHI we receive in the future. We will post the current notice in our offices and on our website at ascendmb.com/notice-of-privacy-practices/. The notice will contain the effective date on the first page. You may request a copy of the current notice at any time.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our practice or with the U.S. Department of Health and Human Services.

You will not be penalized or retaliated against for filing a complaint.

Contact Information

For questions about this notice or to exercise any of your rights, contact: