Your Information. Your Rights. Our Responsibilities.

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.

Your Rights

You have the right to:

• Get a copy of your paper or electronic medical record
• Correct your paper or electronic medical record
• Request confidential communication
• Ask us to limit the information we share
• Get a list of those with whom we’ve shared your information
• Get a copy of this privacy notice
• Choose someone to act for you
• File a complaint if you believe your privacy rights have been violated

Your Choices

You have some choices in the way that we use and share information as we:

• Provide behavioral health services
• Share information with family members, legal guardians, and others involved in your child’s care, or payment for care, as permitted by law
• Provide disaster relief
• Market our services

Our Uses and Disclosures

We may use and share your information as we:

• Treat you
• Run our organization
• Bill for your services
• Help with public health and safety issues
• Do research
• Comply with the law
• Work with a medical examiner or funeral director
• Address workers’ compensation, law enforcement, and other government requests
• Respond to lawsuits and legal actions

To the extent that we have your substance use disorder patient records, subject to 42 CFR part 2, we will not share that information for investigations or legal proceedings against you without (1) your written consent or (2) a court order and a subpoena.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record

• You can ask to see or obtain an electronic or paper copy of your medical record and other health information we maintain about you. Please contact us for information about submitting a request.
• We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record

• You can ask us to correct health information about you that you believe is incorrect or incomplete. Please contact us for information about submitting a request.
• We may deny your request in certain circumstances, but we will provide a written explanation within 60 days.

Request confidential communications

• You can request that we contact you in a specific way (for example, home, office, or cell phone) or to send mail to a different address.
• We will accommodate to all reasonable requests.

Ask us to limit what we use or share

• You may request that we not use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and may deny it in certain circumstances, for example, if it could affect your care. If we agree to your request, we may still share this information in the event that you need emergency treatment.
• If you pay for a service in full out-of-pocket, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will honor this request unless we are required by law to share the information.

Get a list of those with whom we’ve shared information

• You may request a list (accounting) of certain disclosures of your health information made during the six years prior to the date of your request. The list will include who we shared the information with and the reason for the disclosure.
• We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

You may request a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

• If another person is authorized to act as your personal representative, such as if someone has your medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

• If you believe your privacy rights have been violated, you may file a complaint by contacting us using the contact information provided at the end of this notice.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting https://www.hhs.gov/hipaa/filing-a-complaint/index.html.
• We will not retaliate against you for exercising your privacy rights or filing a complaint.

Your Choices

For certain health information, you can tell us your preferences regarding how we share your information. If you have a preference regarding the situations described below, please let us know and we will follow your instructions when permitted by law.

In these situations, you have both the right and choice to tell us whether to:

• Share information with family members, legal guardians, and others involved in your child’s care or payment for care, as permitted by law
• Share information in a disaster relief situation

If you are unable to communicate your preferences, for example due to an emergency, we may share your information if we determine it is in your best interest. We may also share information when necessary to prevent or lessen a serious and imminent threat to health or safety.

We will not use or disclose your information for the following purposes without your written authorization:

• Use your information for marketing purposes
• Sell your information

Our Uses and Disclosures

How do we typically use or share your health information?

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

Treat you

We can use your health information and share it with other professionals who are treating you.

Example: Members of your child’s treatment team may share health information with one another to develop, implement, and monitor your child’s treatment plan.

Run our organization

We can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use health information to train staff, provide clinical supervision, and improve the quality of the services we provide.

Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities.

Example: We provide information to your health insurance plan to support authorization, billing, and payment for your services.

How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.

In all cases, including those listed below, if we have substance use disorder patient records about you, subject to 42 CFR part 2, we cannot use or share information in those records in civil, criminal, administrative, or legislative investigations or proceedings against you without (1) your consent or (2) a court order and a subpoena.

Help with public health and safety issues

We can share health information about you for certain situations such as:

• Supporting public health activities required by law
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety

Do research

We can use or share your information for health research.

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests

We can use or share health information about you:

• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

• We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. We will follow or exceed the federal reporting timelines of 60 days unless your state has a shorter reporting timeline.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share 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. Let us know in writing if you change your mind.
• We will not use your information for marketing purposes without your written authorization.
• We will never sell your personal information.
• We will honor state health privacy laws when they provide stronger protections.

State Privacy Rights

Residents of certain states may have additional privacy rights under applicable state law. As noted above, we will honor state health privacy laws when they provide stronger protections. Please refer to applicable state privacy addendum for information about state-specific privacy rights and protections.

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.

Other Instructions for Notice

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

• Effective Date of this Notice: February 16, 2026
• For questions, please contact:
  • HIPAA Security Officer: Mark Weaver: mweaver@lovaas.com (856) 616-9442 ext. 121
  • HIPAA Privacy Officer: Simone Stevens: sstevens@lovaas.com (856) 616-9442 ext. 105

 

This addendum applies to individuals who receive services in California.

In addition to the rights described in our Notice of Privacy Practices, California law, including the California Confidentiality of Medical Information Act (CMIA), may provide additional protections for your medical information. When California law provides greater privacy protections than federal law, we will comply with California law.

Additional Privacy Protections

California law may require your written authorization before certain uses or disclosures of medical information that would otherwise be permitted under federal law.

Marketing Communications

We will not use or disclose your health information for marketing purposes without your written authorization, except as otherwise permitted by law.

Breach Notification

If a breach of unsecured protected health information occurs, we will provide notice in accordance with applicable federal and California law.

Questions About Your Privacy Rights

If you have questions regarding your privacy rights under California law, please contact our HIPAA Privacy Officer using the contact information provided in this Notice of Privacy Practices.

 

This addendum applies to individuals who receive services in Minnesota.

• Minnesota Health Records Act
• Health record access rights
• Health record release and consent protections

In addition to the rights described in our Notice of Privacy Practices, the Minnesota Health Records Act may provide additional rights and protections regarding your health information. When Minnesota law provides greater privacy protections than federal law, we will comply with Minnesota law.

Minnesota law provides rights regarding access to and copies of your health records. Additional information about these rights is provided in the Minnesota Department of Health Access to Health Records Notice of Rights.

Access to Health Records Notice of Rights: https://www.health.state.mn.us/facilities/notices/docs/notice.pdf

Release of Health Information

We will use and disclose your health information in accordance with applicable federal and Minnesota law. When Minnesota law requires your consent or authorization for a disclosure, we will obtain it before disclosing your information.

Questions About Your Privacy Rights

If you have questions regarding your privacy rights under Minnesota law, please contact our HIPAA Privacy Officer using the contact information provided in this Notice of Privacy Practices.

 

This addendum applies to individuals who receive services in Nebraska.

 

• Nebraska law may provide additional privacy protections. Where Nebraska law provides greater protection than HIPAA, we will comply with the more protective law.

This addendum applies to individuals who receive services in New Jersey.

 

• New Jersey law may provide additional privacy protections. Where New Jersey law provides greater protection than HIPAA, we will comply with the more protective law.

This addendum applies to individuals who receive services in Pennsylvania.

• HIV confidentiality
• Mental health confidentiality (if applicable)
• SUD confidentiality cross-reference

In addition to the rights described in our Notice of Privacy Practices, Pennsylvania law may provide additional protections for certain health information. When Pennsylvania law provides greater privacy protections than federal law, we will comply with Pennsylvania law.

 

Additional Privacy Protections

HIV-Related Information

Pennsylvania law provides special protections for HIV-related information. In many circumstances, we may not disclose HIV-related information without your specific written authorization unless otherwise permitted or required by law.

Mental Health Information

Certain mental health treatment records may be subject to additional confidentiality protections under Pennsylvania law. When applicable, we will comply with those requirements before disclosing such information.

Substance Use Disorder Records

Substance use disorder treatment records may be protected by federal law (42 CFR Part 2) and, in some circumstances, Pennsylvania law. When these protections apply, your written authorization may be required before information is disclosed, unless disclosure is otherwise permitted or required by law.

Questions About Your Privacy Rights

If you have questions regarding your privacy rights under Pennsylvania law, please contact our HIPAA Privacy Officer using the contact information provided in this Notice of Privacy Practices.