
Notice of Privacy Practices
Mindwave Therapy is committed to protecting the privacy of your health information. As a coordinated care provider offering therapy services across multiple states, we may receive, create, and disclose your protected health information (PHI) in the course of delivering care. This Notice explains how your information may be used or shared, and outlines your rights regarding that information.
We are required by law to maintain the privacy and security of your PHI and to provide you with this notice of our legal duties and privacy practices.
Please read this notice carefully. It explains how your health information may be used and disclosed, and how you can access this information.
YOUR RIGHTS
When it comes to your health information, you have certain rights. This section explains those rights and our responsibilities.
Get an electronic or paper copy of your medical record
You can ask to see or obtain a copy of your health record.
We will provide access within 30 days of your request. A reasonable, cost-based fee may apply.
Ask us to correct your medical record
You can request corrections to your health information if you believe it's incorrect or incomplete.
We may decline the request, but we’ll explain why in writing within 60 days.
Request confidential communications
You can ask us to contact you in a specific way (e.g., at home or at work).
We will accommodate 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 operations.
We are not required to agree, but we will comply when legally obligated or feasible.
If you pay out of pocket for a service, you can request that we not share that information with your insurer. We will honor this unless the law requires otherwise.
Get a list of those with whom we’ve shared information
You can ask for a list of the disclosures we’ve made of your health information (except for treatment, payment, operations, and some others) over the past six years.
One free request per year; additional requests may incur a reasonable fee.
Get a copy of this notice
You can request a paper copy of this notice at any time.
Choose someone to act for you
If you’ve designated a medical power of attorney or legal guardian, that person may act on your behalf.
File a complaint if you feel your rights are violated
Contact us using the information provided on our website.
You may also file a complaint with the U.S. Department of Health and Human Services.
We will not retaliate against you for filing a complaint.
YOUR CHOICES
For certain health information, you have a choice in how we use or share it. If you have a clear preference, tell us and we will follow your instructions.
In these cases, you have the right to tell us to:
Share information with family, friends, or others involved in your care
Share information in disaster relief situations
Include your information in a facility directory (if applicable)
If you are unable to express a preference, we may share your information if we believe it’s in your best interest or to prevent a serious health threat.
In these cases, we never share your information unless you give written permission:
Marketing purposes
Sale of your information
Most disclosures of psychotherapy notes
In the case of fundraising:
We may contact you for fundraising purposes. You can ask us not to contact you again.
OUR USES AND DISCLOSURES
We typically use or share your health information to:
Treat you
Share with other professionals involved in your care.
Example: A provider consults with another clinician.
Run our organization
Manage operations and improve care.
Example: Reviewing client outcomes to improve services.
Bill for your services
Share necessary information with insurers for reimbursement.
Example: Sending claim info to your insurance provider.
OTHER WAYS WE MAY SHARE YOUR INFORMATION
We are allowed or required to share your health information in these situations, provided specific legal conditions are met:
Public health activities (e.g., disease prevention, product recalls)
Reporting abuse, neglect, or domestic violence
Preventing or reducing serious health threats
Health research (in compliance with applicable laws)
Compliance with federal or state law
Organ and tissue donation requests
Medical examiner, coroner, or funeral director purposes
Workers' compensation and law enforcement activities
Health oversight activities (audits, inspections)
Special government functions (e.g., national security, military)
Legal proceedings (in response to court orders or subpoenas)
ACCESS TO RECORDS
To request access to your health records:
Submit a written request to: scheduling@mindwavetherapy.com
Your request will be reviewed by authorized staff.
When appropriate, you may review the records with a provider.
Copies will be provided within 14–30 days, depending on state law.
A small fee may apply for copies; you will be informed in advance.
OUR RESPONSIBILITIES
We are required by law to protect your PHI.
We will notify you promptly if a breach occurs that may compromise your information.
We must follow the terms of this notice and provide a copy to you.
We will not share your information unless you authorize us in writing, except as described above.
You can revoke your authorization at any time in writing.
Learn more: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html
CHANGES TO THIS NOTICE
We may update this notice at any time. The revised notice will apply to all PHI we maintain and will be available on our website and upon request.