Notice of Privacy Practices
Effective Date: September 6, 2026
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
Our Responsibilities
Embers of Peace & Wellness LLC is required by law to maintain the privacy of protected health information (PHI), provide you with this notice of our legal duties and privacy practices, follow the terms of the notice currently in effect, and notify affected individuals following a breach of unsecured PHI when required by law.
How We May Use and Disclose Your PHI
Treatment
We may use or disclose PHI to provide, coordinate, or manage your healthcare and related services. This may include communicating with other healthcare professionals involved in your care when permitted by law.
Payment
We may use or disclose PHI to obtain payment for services, process claims when applicable, or manage billing and collections as permitted by law.
Healthcare Operations
We may use or disclose PHI for activities necessary to operate the practice, such as quality assessment, care coordination, compliance, credentialing, and administrative activities, as permitted by law.
Other Permitted or Required Uses
We may use or disclose PHI without your written authorization when permitted or required by law, including for public health activities, reporting abuse or neglect when required, health oversight activities, certain legal proceedings, law enforcement requests under applicable law, preventing a serious threat to health or safety, workers’ compensation, and other purposes authorized by law.
Uses Requiring Your Written Authorization
Most uses and disclosures of psychotherapy notes, uses or disclosures for marketing, and other uses or disclosures not described in this notice generally require your written authorization when required by HIPAA. You may revoke an authorization in writing to the extent permitted by law, except to the extent action has already been taken in reliance on it.
Your Privacy Rights
- Right to inspect and copy: You may request access to your PHI, subject to applicable legal limitations.
- Right to request an amendment: You may ask us to correct or amend PHI that you believe is inaccurate or incomplete, subject to applicable rules.
- Right to an accounting: You may request an accounting of certain disclosures of PHI.
- Right to request restrictions: You may ask us to restrict certain uses or disclosures. We are not required to agree to every request, except where required by law.
- Right to confidential communications: You may request that we communicate with you by alternative means or at alternative locations when permitted.
- Right to a paper copy: You may request a paper copy of this notice at any time.
- Right to complain: You may complain to us or to the U.S. Department of Health and Human Services if you believe your privacy rights have been violated. You will not be retaliated against for filing a complaint.
Special Protections
Certain types of information may receive additional protection under federal or state law, including certain mental health records, psychotherapy notes, substance use disorder records subject to applicable federal requirements, genetic information, HIV-related information, and other specially protected records. We will follow applicable law when handling such information.
Electronic and Telehealth Communications
We may communicate with you electronically when permitted and when appropriate safeguards are used. Please do not send highly sensitive health information through ordinary email, text message, or social media unless specifically instructed to do so through a secure process.
Changes to This Notice
We reserve the right to change this notice. If we make a material change to our privacy practices, we will revise the notice and make the updated notice available as required by law, including by posting it on our website.
Contact Us or File a Complaint
Embers of Peace & Wellness LLC
Phone: 943-300-5764
Email: lrimentalnp@emberspw.net
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.