Your Choices | Your Rights | Our Responsibilities
This notice describes how your protected health information may be used or disclosed and how you can get access to this information. Please review it carefully.
P'AZ Integrative Psychiatry & Wellness PLLC (“we,” “our,” or “P'AZ”) is committed to protecting your privacy. As a provider of integrated psychiatric care, mental health services, and wellness support, we are required by law to keep your information confidential and secure under federal and state law. We are required by law (45 CFR Parts 160 and 164) to maintain the privacy and security of your protected health information (“PHI”).
Your Choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, please contact us using the contact information provided at the bottom of this Notice and we will make reasonable efforts to follow your instructions.
In these cases, you have both the right and choice to tell us whether to:
Share information, with your family, close friends, or others involved in your care.
Share information in a disaster relief situation, such as to a relief organization to assist with locating or notifying your family, close friends, or others involved in your care.
Exclude your information, such as your name, room number, or general condition from a hospital directory (if applicable).
Use or share substance abuse treatment records about you for fundraising purposes that benefit us.
If you are not able to tell us your preference, for example if you are unconscious, we may share your information if we believe it is in your best interest, according to our best judgment. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases, we will not share your information unless you give us your written permission:
Most sharing of a mental health care professional's notes (psychotherapy notes).
Marketing purposes.
Selling or otherwise receiving compensation for disclosing your PHI.
Certain research activities.
Other uses and disclosures not described in this Notice.
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.
Access to your medical records
You have the right to access and receive copies of your protected health information that we use to make decisions about your care. You must submit a written request to obtain your protected health information to the individual listed at the end of this privacy policy. We reserve the right to charge you a fee for the time it takes to obtain and copy the protected health information and provide it to you.
Amendment
If you believe the protected health information we have about you is incorrect or incomplete, you may ask us to amend the information. You will need to submit a written request on why you feel the health information should be amended. We may deny your request to amend if you did not send a written request or give a reason on why it should be amended. If we deny your request, we will provide you a written explanation. We may deny your request if we believe the protected health information is accurate and complete.
Accounting of Disclosures
You have the right to receive a list of instances in which we disclosed your personal health information unless the disclosure was used for treatment, payment, healthcare operations, was pursuant to a valid authorization and as otherwise provided in applicable federal and state laws and regulations. You must submit a written request to obtain this “accounting of disclosures” to the individual listed at the bottom of this policy. After your request has been approved, we will provide you the dates of the disclosure, the name of the individual or entity we disclosed the information to, a description of the information that was disclosed, the reason why it was disclosed, and any additional pertinent information. This information may not be longer than six years ago prior to the date the accounting is requested. We reserve the right to charge a reasonable fee for this process.
Restriction Requests
You have the right to request a restriction or limitation on the protected health information we use or disclose about you for treatment, payment, or healthcare operations. We shall accommodate your request except where the disclosure is required by law. We require this to be a written request submitted to the individual at the end of this policy.
Confidential Communication
You have the right to request that we communicate with you about healthcare matters in a certain way and at a certain location. We must accommodate your request if it is reasonable and allows us to continue to collect payments and bill you.
Paper copy of this notice
You may request a hard copy of this practice policy if you reviewed and signed it via electronic means. To obtain this copy, contact the person at the end of this privacy policy.
Choose someone to act for you
You have a right to choose someone to act on your behalf, such as a personal representative. This individual, often a family member or legal guardian, can exercise your rights regarding your health information, including accessing, amending, or directing the release of information.
File a complaint if your rights have been violated
If you believe your privacy rights have been violated, you may file a complaint with our office. 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 www.hhs.gov/ocr/privacy/hipaa/complaints/.
We will not retaliate against you for filing a complaint.
Our Uses and Disclosures for Treatment, Payment, or Health Care Operations
Your Treatment
We may use and disclose your protected health information to provide you treatment. This includes disclosing your protected health information to other medical providers, trainees, therapists, medical staff, and office staff that are involved in your health care.
Example: Your medical provider might need to consult with another provider to coordinate your care. Also, the office staff may need to use and disclose your protected health information to other individuals outside of our office such as the pharmacy when a prescription is called in.
Your Payment or Billing Services
Your protected health information may also be used to obtain payment from an insurance company or another third part.
Example: This may include providing an insurance company your protected health information for a pre-authorization for a medication we prescribed.
Health Care Operations
We may use or disclose your protected health information in order to operate this medical practice. These activities include training students, reviewing cases with employees, utilizing your information to improve the quality of care, and contacting you by telephone, email, or text to remind you of your appointments.
Example: This may include using your protected health information to evaluate a providers performance to enhance service quality.
Other Uses and Disclosures
In certain limited situations federal and state law may require us to share your protected health information to protect public health, research purposes or to comply with a court order.
These other uses and disclosures may involve:
Required By Law: We only share your information if the law explicitly permits or requires it, and we ensure that disclosures are limited to the absolute minimum necessary.
Health Oversight Activities: We may disclose protected health information to health oversight agencies for audits, investigations, inspections or licensing purposes. These disclosures might be necessary for state and federal agencies to monitor healthcare systems and compliance with civil law.
Public Health Risks: We may disclose your protected health information, if necessary, in order to prevent or control disease, report adverse events from medications or products, prevent injury, disability or death. This information may be disclosed to healthcare systems, government agencies, or public health authorities. We may have to disclose your protected health information to the Food and Drug Administration to report adverse events, defects, problems, enable recalls etc. if required by FDA regulation.
Research; We will not use or disclose your health information for research purposes unless you give us authorization to do so.
Organ and Tissue Donation: If you are an organ donor, we may release protected health information to organizations that handle organ procurement or organ, eye or tissue transplantation if it is necessary to facilitate this process.
Appointment reminders: We may contact you as a reminder that you have an appointment for your initial visit, follow up visit, or lab work via text, phone or email.
Others Involved in Your Health Care: We may disclose protected health information about you to your family members or friends if we obtain your verbal agreement to do so, or if we give you an opportunity to object to such a disclosure and you do not raise an objection. We may assume that if your spouse or friend is present during your evaluation, that we can disclose protected professional information to this person. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment if there is an urgent or emergent need.
Workman’s compensation: We may disclose your protected health information to workman’s comp or similar programs.
Lawsuits: We may disclose your protected health information in response to a court action, administrative action or a subpoena.
Law Enforcement: We may release protected health information to a law enforcement official in response to a court order, subpoena, warrant, subject to all applicable legal requirements.
Fundraising: P'AZ Integrative Psychiatry & Wellness does not use or share your information for fundraising purposes. For more information on permitted uses and disclosures, see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
If we have to share your protected health information to third party “business associates” such as a billing service, if so, we will have a written contract that contains terms that will protect the privacy of your protected health information.
We will not use or disclose your protected health information for any purpose other than those identified in this policy without your specific, written Authorization. You may give us written authorization to use your protected health information or to disclose it to anyone for any purpose. You can revoke this authorization at any time but will not affect the protected health information that was shared while the authorization was in effect.
Our Responsibilities
We are required by law to give you this notice. It explains how we may use and disclose protected health information about you and describes your rights and our obligations regarding the use and disclosure of that information.
We will maintain the privacy of protected health information and provide you with notice of our legal duties and privacy practices with respect to your protected health information.
We will not use or share your information other than as described here unless you give us written permission. If you do, you may change your mind at any time in writing.
You may request a copy of our notice any time. You may contact P'AZ Integrative Psychiatry & Wellness PLLC at any time to request a copy of this privacy policy.
Data Breach Notification
We will promptly notify you if a data breach occurs that may have compromised the privacy or security of your PHI. We will notify you within the legally required time frame/no later than 60 days after we discover the breach. Most of the time, we will notify you in writing, by first-class mail, or we may email you if you have provided us with your current email address and you have previously agreed to receive notices electronically. In some circumstances, our business associates, which are described in more detail below, may provide the notification. In limited circumstances when we have insufficient or out-of-date contact information, we may provide notice in a legally acceptable alternative form.
Changes to the Terms of This Notice
We have the right to change these policies at any time. If we change our privacy policies, we will notify you of these changes immediately.
This current policy is in effect unless stated otherwise. If the policy is changed, it will apply to all your current and past health information.
Scope
Arizona State (ARS 36-2272, ARS 44-133.01): Youth age 12 and older may consent to their own substance use treatment, including outpatient and inpatient care related to drug or narcotic use or withdrawal. For mental health treatment, both inpatient and outpatient, parental or guardian consent is generally required, except in emergencies to prevent serious harm or in cases involving emancipated, married, or homeless youth. Parents/guardians have automatic access to mental health records but cannot access substance use records without the youth's authorization if the youth consented to treatment, unless required by law (e.g., child abuse reporting). Providers must notify parents for inpatient substance use admissions but may share limited information with parents or guardians if clinically appropriate and necessary to prevent serious harm to the youth or others, consistent with HIPAA, 42 CFR Part 2, and state confidentiality rules.
Washington State (RCW 71.34, RCW 70.02): Youth age 13 and older may consent to their own mental health and substance use treatment. Parents/guardians cannot access these records without youth authorization unless required by law. Providers may, but are not required to, share certain limited information with parents or guardians if it is clinically appropriate and necessary to prevent a serious harm to the youth or others, consistent with RCW 71.34.530.
Oregon State (ORS 109.675): Youth age 14 and older may consent to their own outpatient mental health or substance use treatment. Providers must attempt to involve parents before the end of treatment unless refused or clinically inappropriate. Parents do not have automatic access to youth records without the youth’s written authorization, except as required by law.
Redisclosure Prohibited: Arizona, Washington, and Oregon law, supplemented by federal regulations, prohibits redisclosure of mental health and substance use records without specific written consent from the individual who authorized the initial disclosure.
We create a record of the care and health services you receive, to provide your care, and to comply with certain legal requirements. This Notice applies to all the PHI that we generate and to substance use treatment-related records (substance use treatment records) under 42 U.S.C. §290dd-2 and 42 C.F.R. Part 2 (Part 2) that we receive or maintain. We also follow the confidentiality protections of Part 2 for such records.
Psychotherapy Notes: HIPAA provides these with heightened privacy safeguards, meaning they won't be disclosed without your explicit written permission—unless disclosure is legally required. Unlike your primary medical record, these notes are kept apart and capture your therapist's private reflections from therapy sessions.
We and our employees and other workforce members follow the duties and privacy practices that this Notice describes and any changes once they take effect.
How We May Use or Disclose Your PHI Uses and Disclosures of Your PHI
The law permits or requires us to use or disclose your PHI for various reasons, which we explain in this Notice. We have included some examples, but we have not listed every permissible use or disclosure. When using or disclosing PHI or requesting your PHI from another source, we will make reasonable efforts to limit our use, disclosure, or request about your PHI to the minimum we need to accomplish our intended purpose. PHI that the law permits or requires us to disclose may be further shared by recipients and is no longer protected by law or the safeguards and restrictions in place when it is in our possession.
This notice is effective as of August 15, 2025.
Contact Information
Privacy Officer: Chief Operating Officer/Privacy Officer
Phone: (928) 382-3192
Fax: (949) 864-3504
Email: connect@psychiatry-az.com
Acknowledgment of Receipt of Notice of Privacy Practices
HIPAA requires us to make a good faith effort to obtain your written acknowledgment that you have received a copy of our Notice of Privacy Practices (45 CFR §164.520(c)(2)). You are not required to sign.