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Privacy

Notice of Privacy Practices

Atlanta Children’s Center for Developmental and Behavioral Health, LLC

Tiffany Aronson, PsyD; Christine Hall, PhD; Sara Hoffenberg, PsyD, ABPP; Christa Aoki, PhD, ABPP; Amy Kincheloe, PhD; Michelle Mastin, PhD; Shana Richardson, PhD, ABPP; Suzanne Urquhart, MEd, CCC-SLP

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.

I. Our Pledge Regarding Health Information

We understand that health information about you, your child, and your health care is personal, and we are committed to protecting it. We create a record of the care and services you receive from us. We need this record to provide quality care and to comply with certain legal requirements. This Notice applies to all records of care generated by this practice. It describes the ways we may use and disclose health information about you, your rights regarding the health information we keep, and our obligations regarding its use and disclosure.

We are required by law to:

  • Maintain the privacy of protected health information (“PHI”) that identifies you.
  • Give you this Notice of our legal duties and privacy practices with respect to PHI.
  • Notify you if there is a breach of your unsecured PHI.
  • Follow the terms of the Notice that is currently in effect.

We reserve the right to change the terms of this Notice, and any changes will apply to all PHI we maintain about you. A revised Notice will be posted in our office and on our website, and will be available upon request.

II. How We May Use and Disclose Health Information About You

The following categories describe different ways we use and disclose health information. For each category, we explain what we mean and give examples. Not every use or disclosure in a category is listed, but all of the ways we are permitted to use and disclose information fall within one of these categories.

Treatment. We may use and disclose your PHI to provide, coordinate, or manage your care, including for the treatment activities of other health care providers. For example, a clinician may consult with another licensed health care provider about your condition to assist in diagnosis and treatment. Disclosures for treatment purposes are not limited to the minimum necessary standard, because clinicians and other health care providers need access to full and complete information to provide quality care. “Treatment” includes coordination and management of care with a third party, consultations between health care providers, and referrals from one provider to another.

Payment. We may use and disclose your PHI to bill and receive payment for the services you receive. For example, we may send your health insurance company information about the dates of service and the services provided so that we can be paid or you can be reimbursed.

Health Care Operations. We may use and disclose your PHI to run our practice and improve the quality of care. For example, we may review records to evaluate our services, train clinicians, or work with business associates, such as billing or electronic records companies, who are required by contract to protect your information.

Lawsuits and Disputes. If you are involved in a lawsuit, we may disclose health information in response to a court or administrative order. We may also disclose health information about you or your child in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

III. Certain Uses and Disclosures Require Your Authorization

Psychotherapy Notes. In some cases we keep “psychotherapy notes,” as that term is defined in 45 CFR § 164.501. Any use or disclosure of these notes requires your written authorization unless the use or disclosure is:

  1. For our use in treating you or your child.
  2. For our use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy.
  3. For our use in defending ourselves in legal proceedings instituted by you.
  4. For use by the Secretary of Health and Human Services to investigate our compliance with HIPAA.
  5. Required by law, and the use or disclosure is limited to the requirements of such law.
  6. Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes.
  7. Required by a coroner who is performing duties authorized by law.
  8. Required to help avert a serious threat to the health and safety of others.

Marketing Purposes. We will not use or disclose your PHI for marketing purposes.

Sale of PHI. We will not sell your PHI.

Other Uses and Disclosures. Any use or disclosure of your PHI not described in this Notice will be made only with your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.

IV. Certain Uses and Disclosures Do Not Require Your Authorization

Subject to certain limitations in the law, we may use and disclose your PHI without your authorization for the following reasons:

  • When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of that law.
  • For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.
  • For health oversight activities, including audits and investigations.
  • For judicial and administrative proceedings, including responding to a court or administrative order, although our preference is to obtain your authorization before doing so.
  • For law enforcement purposes, including reporting crimes occurring on our premises.
  • To coroners or medical examiners, when they are performing duties authorized by law.
  • For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.
  • For specialized government functions, including ensuring the proper execution of military missions, protecting the President of the United States, conducting intelligence or counter-intelligence operations, or helping to ensure the safety of those working within or housed in correctional institutions.
  • For workers’ compensation purposes. Although our preference is to obtain your authorization, we may provide your PHI to comply with workers’ compensation laws.
  • For appointment reminders and health-related benefits or services. We may use and disclose your PHI to remind you of an appointment or to tell you about treatment alternatives or other health care services or benefits we offer.

Redisclosure. Information we disclose as permitted by law may be redisclosed by the person or organization that receives it and may no longer be protected by federal privacy rules.

V. Certain Uses and Disclosures Require You to Have the Opportunity to Object

Disclosures to Family, Friends, or Others. We may provide your PHI to a family member, friend, or other person you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. In emergency situations, the opportunity to consent may be obtained retroactively.

VI. Your Rights Regarding Your PHI

To exercise any of the rights below, please contact our Privacy Officer using the information in Section VIII.

The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask us not to use or disclose certain PHI for treatment, payment, or health care operations purposes. We are not required to agree to your request, and we may say “no” if we believe it would affect your health care, except as described in the next paragraph.

The Right to Request Restrictions for Out-of-Pocket Expenses Paid in Full. You have the right to request that we not disclose your PHI to a health plan for payment or health care operations purposes if the PHI pertains solely to a health care item or service you have paid for out-of-pocket in full. We will agree to this request unless the law requires us to share the information.

The Right to Choose How We Send PHI to You. You have the right to ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address, and we will agree to all reasonable requests.

The Right to See and Get Copies of Your PHI. Other than psychotherapy notes, you have the right to get an electronic or paper copy of your medical record and other information we have about you. We will provide a copy of your record, or a summary of it if you agree to receive a summary, within 30 days of receiving your written request, and we may charge a reasonable, cost-based fee.

The Right to Get a List of the Disclosures We Have Made. You have the right to request a list of instances in which we have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided an authorization. We will respond within 60 days of receiving your request. The list will include disclosures made in the last six years unless you request a shorter time. We will provide the list at no charge, but if you make more than one request in the same year, we may charge a reasonable, cost-based fee for each additional request.

The Right to Correct or Update Your PHI. If you believe there is a mistake in your PHI, or that important information is missing, you have the right to request that we correct or add to it. We may say “no” to your request, but we will tell you why in writing within 60 days of receiving your request.

The Right to Get a Paper or Electronic Copy of This Notice. You have the right to get a paper copy of this Notice, and you have the right to get a copy by email. Even if you have agreed to receive this Notice by email, you also have the right to request a paper copy.

VII. Complaints

If you believe your privacy rights have been violated, you may file a complaint with us by contacting our Privacy Officer using the information below. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue SW, Washington, DC 20201, by calling 1-877-696-6775, or online at www.hhs.gov/ocr/complaints. We will not retaliate against you for filing a complaint.

VIII. Contact Information

For questions about this Notice, to exercise your rights, or to file a complaint, please contact:

Privacy Officer Atlanta Children’s Center for Developmental and Behavioral Health, LLC 2751 Buford Hwy NE, Suite 207, Atlanta, GA 30324 Phone: 404-618-0505 Email: admin@atlantachildrenscenter.com

Effective Date of This Notice

This Notice is effective as of October 9, 2026. It replaces the Notice effective September 20, 2013.