NOTICE OF PRIVACY PRACTICES
Effective Date: April 14, 2026

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.

Sabanosh Psychiatry & Wellness, LLC is committed to protecting the privacy of your health information. This Notice describes how we may use and disclose your protected health information (“PHI”), your rights regarding that information, and our legal duties under the Health Insurance Portability and Accountability Act (“HIPAA”).

Your Rights

You have the right to:

Get a copy of your medical record
You can ask to inspect or get a copy of your medical record and certain other health information we maintain about you. We may charge a reasonable, cost-based fee for copies as permitted by law.

Ask us to correct your medical record
You can ask us to correct health information about you that you believe is incorrect or incomplete. We may deny your request in certain circumstances, but we will explain why in writing.

Request confidential communications
You can ask us to contact you in a specific way, such as at a certain phone number, email address, mailing address, or in sealed mail only. We will accommodate reasonable requests.

Ask us to limit what we use or share
You can ask us not to use or share certain health information for treatment, payment, or healthcare operations. We are not required to agree to all requests, but we will consider them carefully.

Get a list of certain disclosures
You can ask for an accounting of certain disclosures of your health information made by us.

Get a copy of this notice
You can ask for a paper copy of this Notice at any time, even if you agreed to receive it electronically.

Choose someone to act for you
If you have given someone medical power of attorney or if someone is your legal guardian, that person may exercise your rights and make choices about your health information, as permitted by law.

File a complaint
You may file a complaint with us if you believe your privacy rights have been violated. 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. 

Your Choices

For certain health information, you can tell us your choices about what we share. For example, you may have the right to tell us whether to share information:

• With family members, friends, or others involved in your care

• In disaster relief situations

• In a facility directory, if applicable

If you are not able to tell us your preference, we may share information if we believe it is in your best interest, as permitted by law.

We will not use or share your information for marketing purposes or sell your information without your written authorization unless allowed by law.

Most uses and disclosures of psychotherapy notes require your written authorization, except in limited situations permitted by law.

You may revoke an authorization in writing at any time, except to the extent we have already relied on it.

Our Uses and Disclosures

We typically use or share your health information in the following ways:

For treatment
We may use and share your health information to provide, coordinate, or manage your treatment and related services.
Example: We may share information with another healthcare provider involved in your care.

For payment
We may use and share your health information to bill and receive payment for services we provide.
Example: We may share information with your health insurance plan to obtain payment.

For healthcare operations
We may use and share your health information to run our practice, improve care, evaluate provider performance, conduct quality assessment activities, train staff, and carry out other business operations.
Example: We may review your information to improve our clinical and administrative processes.

Other Ways We May Use or Share Your Information

We may also use or disclose your health information when required or permitted by law, including:

• To comply with federal, state, or local law

• For public health activities

• To report abuse, neglect, or domestic violence when required or permitted

• For health oversight activities

• In response to court orders, subpoenas, or lawful process

• For law enforcement purposes in limited circumstances

• To avert a serious threat to health or safety

• For workers’ compensation claims, as applicable

• For specialized government functions, as permitted by law

• To coroners, medical examiners, or funeral directors, as permitted by law

Special Protections for Certain Information

Certain categories of information may receive additional protections under applicable law, including information relating to mental health treatment, substance use disorder treatment, HIV/AIDS status, reproductive health information, and minors, depending on the services provided and applicable federal and state law. Additional authorization may be required before certain disclosures are made. HHS also updated HIPAA materials in this area, including reproductive health privacy protections. 

Our Responsibilities

We are required by law to:

• Maintain the privacy and security of your protected health information

• Provide you with this Notice of our legal duties and privacy practices

• Follow the duties and privacy practices described in this Notice

• Notify you if a breach occurs that may have compromised the privacy or security of your information

We will not use or disclose your information other than as described in this Notice unless you tell us we can in writing. If you tell us we can, you may change your mind at any time by notifying us in writing.

Complaints

If you believe your privacy rights have been violated, you may contact:

Privacy Contact for Sabanosh Psychiatry & Wellness, LLC
Director of Operations
8401 Mayland Dr, Suite A, Richmond, VA 23294
info@sabanoshpsychiatry.com

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.