FREDERICK PSYCHIATRY LLC

NOTICE OF PRIVACY PRACTICES

I. PROTECTED HEALTH INFORMATION

Protected Health Information (PHI) is medical information that identifies you or may provide a basis for identifying you, including demographic information. Your PHI relates to your past, present, or future physical or mental health condition and related healthcare services. Frederick Psychiatry LLC is required by law to keep records of the care which is provided to you.


II. MEDICAL RECORDS

A Medical Record is defined as a record of clinical services provided and details of information discussed during a session. This may be in electronic or paper form. Billing records are separate from the medical record.

Release of certain medical information is permitted for purposes such as case consultation, lab investigation, coordination of care, and sometimes billing or insurance purposes. It is not considered PHI if none of that information can identify you.

This notice applies to all of the records of your care generated by this practice. This notice will tell you about the ways in which we may use and disclose health information about you. It also describes your rights to the health information we keep about you and describes certain obligations we have regarding the use and disclosure of your health information.

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


III. USES AND DISCLOSURES OF HEALTH INFORMATION

The following categories describe different ways that we use and disclose health information. For each category, we will explain what we mean and give examples. Not every use or disclosure will be listed, but all uses and disclosures will fall within one of these categories.

Disclosures for treatment purposes are not limited to the minimum necessary standard, as other healthcare providers may need access to the full record to provide quality care. "Treatment" includes, among other things, coordination of care, consultations between providers, and referrals.


IV. CERTAIN USES AND DISCLOSURES THAT DO NOT REQUIRE YOUR AUTHORIZATION

Subject to certain legal limitations, we may use and disclose your PHI without your authorization for the following purposes:


V. COMMUNICATIONS BY TEXT MESSAGE (SMS)

By providing your mobile phone number, you consent to receive SMS/text messages from Frederick Psychiatry LLC for purposes including, but not limited to:

Message frequency may vary depending on your appointment schedule and services. **Standard message and data rates may apply.**

We do **NOT** share your mobile number or SMS consent information with third parties, affiliates,or partners for marketing or promotional purposes.

Mobile numbers and consent information are used **solely** to communicate with you regarding your medical needs as specified above.

You may **opt out** of receiving SMS messages at any time by replying "STOP." For assistance or more information, reply "HELP" or contact our office directly.

All mobile numbers and consent information are kept **securely** in compliance with HIPAA and other applicable privacy laws.


VI. YOUR RIGHTS REGARDING YOUR PHI

You have the right to:


VII. EFFECTIVE DATE

This notice goes into effect on the date you sign this document and remains in effect until revised.


ACKNOWLEDGEMENT OF RECEIPT OF PRIVACY NOTICE

**Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have certain rights regarding the use and disclosure of your protected health information.** By signing or checking the box on your intake form, you acknowledge:

Updated May 2025