Notice of HIPAA Privacy Practices

Affiliated Covered Entity

Each of the Axis for Autism professional corporation affiliates together designate themselves as a single Affiliated Covered Entity (“ACE”) for purposes of compliance with HIPAA, including Axis for Autism and related entities. These entities, collectively referred to as “the Companies,” follow the terms of this Notice. Entities, sites, locations, and care providers may share medical information with each other for treatment, payment, or healthcare operations related to the ACE.

Our responsibilities

Under HIPAA, the Companies must protect the privacy of your Protected Health Information (“PHI”). PHI includes information we have created or received regarding your health or payment for your health, medical records and personal information such as your name, social security number, financial information, address, and phone number.

• Protect the privacy of your PHI; employees receive appropriate privacy training
• Provide this Notice of Privacy Practices
• Notify you in the case of a breach of unsecured PHI
• Follow the practices and procedures set forth in the Notice

How we may use and disclose PHI

Without your authorization, we may use or disclose PHI for:

• Treatment, coordinating care among providers involved in your healthcare
• Payment, billing, claims, and payment activities permitted by law
• Healthcare operations, quality improvement, training, and business activities as allowed by law

We may also use or disclose PHI when required by law, for public health and safety, abuse or neglect reporting, legal proceedings, law enforcement in certain circumstances, and other purposes described in the full Notice, including appointment reminders and care-related communications by phone, email, or text.

Uses and disclosures for marketing (except as allowed by HIPAA), sale of information, and most sharing of psychotherapy notes require your written authorization.

Your rights

You have the right to:

• Request restrictions on certain uses and disclosures of your PHI
• Request confidential communications by alternative means or at alternative locations
• Inspect and obtain a copy of your PHI, usually within 30 days
• Request amendment of PHI you believe is incorrect or incomplete
• Receive an accounting of certain disclosures of your PHI
• Receive a paper copy of this Notice
• Receive written notification of a breach of unsecured PHI
• File a complaint without retaliation, with us or with the U.S. Department of Health and Human Services Office for Civil Rights

Some requests must be in writing. We may deny certain requests as permitted by law and will explain our reasons when required.

Communication platforms

If you choose to communicate with us via email, text, or chat, you acknowledge that these methods may not be fully secure. You may notify us at info@axisforautism.com if you prefer not to exchange PHI through those channels.

Changes to this Notice

The Companies may modify this Notice from time to time. The revised Notice applies to all PHI we maintain and will be posted on our website with the date of the last update clearly indicated.

Questions, complaints, and Privacy Officer

For questions about this Notice or to request an additional copy, contact our Privacy Officer:

Phone: (602) 888-8882
Email: info@axisforautism.com
Fax: (602) 883-7254
Mail: Privacy Officer, 1645 E Missouri Ave, Suite 320, Phoenix, AZ 85016

If you believe your privacy rights have been violated, you may file a written complaint with the Privacy Officer at the address above, or with the U.S. Department of Health and Human Services Office for Civil Rights at 200 Independence Avenue, S.W., Washington, D.C. 20201, by calling 1-877-696-6775, or at hhs.gov/ocr/privacy/hipaa/complaints .

This page summarizes essential provisions. The authoritative Notice of HIPAA Privacy Practices contains additional detail on permitted uses, state-specific protections, and patient rights.