Notice of Privacy Practices

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.

About this notice

This notice explains how Conscious Integrative Therapy LCSW PLLC (“the practice,” “we,” or “us”) may use and disclose your protected health information, your privacy rights, and our responsibilities. It applies to health information we create, receive, or maintain in providing clinical services through TrancePlan, including psychotherapy, clinical hypnotherapy, and telehealth services.

Billing for TrancePlan services is handled directly by the practice. This notice describes the practice’s handling of clinical information; it does not describe another clinical platform’s billing or privacy practices.

Protected health information includes information that identifies you and relates to your health, health care, or payment for your care. This notice addresses clinical health information; it is separate from the website Privacy Policy, which addresses general website data and online features.

Our responsibilities

We are required by law to protect the privacy of your protected health information, safeguard electronic protected health information, provide this notice, and follow the privacy practices described in the notice currently in effect. We must notify you following a breach of unsecured protected health information when notification is required by law.

We will not use or disclose your information beyond the purposes described in this notice unless you authorize us in writing or the law permits or requires the use or disclosure. When New York law or another applicable law provides greater confidentiality protections than HIPAA, we follow the more protective requirements.

How we may use and disclose your information

The following describes uses and disclosures HIPAA may permit without a separate HIPAA authorization. These permissions do not override New York confidentiality requirements, psychotherapy-note protections, or the additional protections for substance use disorder records described below; we obtain consent or authorization whenever applicable law requires it.

• Treatment: We may use your health information to assess your needs, develop a treatment plan, and provide care. For example, Susan may review your history and progress when planning a session or, with any required consent, coordinate care with another treating professional.
• Payment and direct billing: We use information necessary to prepare our own invoices and receipts, record payments, and collect payment for services provided. For example, an invoice may include your name, appointment date, service description, and amount due; if you request additional billing documentation, we provide it consistent with applicable law and your privacy preferences. Any disclosure outside the practice remains subject to applicable consent requirements and restrictions we are required to honor.
• Health care operations: We may use or disclose information to operate the practice, improve care, review service quality, and fulfill administrative responsibilities. For example, we may review records to evaluate treatment quality or arrange secure recordkeeping.
• Technology and other service providers: Handling our own billing does not eliminate privacy obligations for technology used in the practice. If a recordkeeping, telehealth, or other technology vendor handles protected health information on our behalf, we are required to use appropriate safeguards and obtain a business associate agreement when required by HIPAA.
• Appointment reminders and care information: We may contact you about appointments, treatment alternatives, or health-related services, consistent with applicable law and your confidential-communication requests.
• People involved in your care: We may share information relevant to care or payment with a person you identify, with your agreement and any consent required by law. If you cannot express your preferences, limited disclosures may be permitted in your best interests or in an emergency, subject to applicable legal protections.
• Public health and safety: We may disclose information for legally authorized public health activities, such as reporting disease or adverse product reactions, or to help prevent or lessen a serious and imminent threat to health or safety.
• Abuse, neglect, or domestic violence: We may make reports that the law requires or permits, including mandated reports of suspected child abuse or neglect. Other reporting is subject to the applicable legal conditions and confidentiality protections.
• Health oversight: We may disclose information for legally authorized oversight activities, such as audits, licensing reviews, inspections, and investigations.
• Legal proceedings and law enforcement: We may disclose information in response to a valid court order or other legally sufficient process, or for specific lawful law-enforcement purposes, only when applicable requirements are met. A subpoena alone does not automatically authorize disclosure of confidential therapy records.
• Other legally authorized purposes: Subject to the requirements of applicable law, information may be disclosed for workers’ compensation, authorized military or national-security functions, organ or tissue donation, or to a coroner, medical examiner, or funeral director.
• Research: Health information may be used or disclosed for research only when the required legal conditions are met, such as your authorization or a legally permitted waiver, and subject to any stricter confidentiality rules.
• Required by law: We must disclose information when a law requires it, including to the U.S. Department of Health and Human Services when necessary to assess compliance with federal privacy requirements.

Uses requiring your written authorization

Most uses and disclosures of separately maintained psychotherapy notes require your written authorization, except for limited uses or disclosures specifically permitted or required by law. Psychotherapy notes have a special legal definition and are different from ordinary clinical progress notes, diagnoses, treatment plans, and billing records.

Uses and disclosures for marketing that require authorization under HIPAA, and disclosures constituting a sale of protected health information under HIPAA, require your written authorization. Other uses and disclosures not described in this notice require your written authorization unless otherwise permitted or required by law.

You may revoke an authorization in writing by contacting the privacy contact below. Revocation does not undo actions already taken in reliance on your authorization and is subject to other applicable legal limitations.

If we contact you for fundraising, you may opt out of further fundraising communications. If fundraising would use records protected by 42 CFR Part 2, you must first be given a clear and conspicuous opportunity to choose not to receive those communications.

Additional protection for substance use disorder records

Some substance use disorder treatment records are protected by a federal law known as 42 CFR Part 2. These additional protections apply when we receive or maintain records covered by that law; not every reference to substance use in a therapy record is automatically a Part 2 record.

We use and disclose Part 2 records only as Part 2 permits, including obtaining consent when required. A legally valid consent may permit future treatment, payment, and health care operations uses and disclosures; any subsequent use or disclosure remains subject to applicable HIPAA and Part 2 requirements.

Part 2 records received from a covered program, or testimony about their contents, may not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you without your written consent or an appropriate Part 2 court order issued after notice and an opportunity to be heard are provided to you or the record holder. A court order authorizing use or disclosure must also be accompanied by a subpoena or other legal requirement compelling disclosure.

Your rights

You may exercise the following rights by contacting the privacy contact below. We may ask you to submit a request in writing and verify your identity, and we will explain any applicable limits, fees, or review procedures.

• Access your records: You may ask to inspect or receive an electronic or paper copy of health information in the records used to make decisions about your care. We respond within the deadlines required by law and may charge only legally permitted fees; separately maintained psychotherapy notes and certain other information are subject to legal exceptions.
• Request a correction: You may request an amendment if you believe information is inaccurate or incomplete. If we deny the request, we will explain the reason in writing and explain your right to submit a statement of disagreement.
• Request confidential communications: You may ask us to contact you in a particular way or at an alternative location. We will accommodate reasonable requests.
• Request limits on sharing: You may ask us to restrict certain uses or disclosures for treatment, payment, health care operations, or to people involved in your care. We generally are not required to agree, except for restrictions the law requires; if we agree, an emergency-treatment exception may apply.
• Restrict disclosure to your health plan after full self-payment: If you, or someone other than your health plan, pay for a health care item or service out of pocket in full, you may ask us not to disclose information about that item or service to your health plan for payment or health care operations. We must honor a qualifying request unless disclosure is required by law.
• Request an accounting of disclosures: You may request a list of certain disclosures made during the six years before your request. The list excludes disclosures for treatment, payment, health care operations, and other legally excluded categories; the first accounting in a 12-month period is free, and any additional fee must comply with law.
• Receive a copy of this notice: You may request a paper copy at any time, even if you previously agreed to receive it electronically. You may also request an electronic copy.
• Have an authorized representative act for you: A person with legally recognized authority may exercise applicable rights on your behalf. We verify that authority before acting and apply any legally permitted exceptions.
• File a complaint: You may complain to the practice or to the U.S. Department of Health and Human Services if you believe your privacy rights have been violated. We will not retaliate against you for filing a complaint.

Online communications and the website assistant

Please do not submit clinical histories, diagnoses, treatment details, or other sensitive health information through the public website chatbot or general website forms. The TrancePlan Assistant is an automated educational tool, not a clinical intake channel or emergency service.

Contact Susan to arrange an appropriate communication method for clinical information. These precautions do not remove our legal obligations if protected health information is received through a website feature, and this notice does not authorize an otherwise impermissible disclosure to an AI or technology vendor.

Questions, requests, and complaints

To exercise a privacy right, request more information, or file a complaint with the practice, contact Susan using the details above. You may begin with a general request without including sensitive health information; Susan will explain how to provide any necessary details through an appropriate channel.

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, through the HHS privacy complaint website. The HHS model notice also provides the contact address 200 Independence Avenue, S.W., Washington, D.C. 20201 and telephone number 1-877-696-6775.

Changes to this notice

We reserve the right to change this notice and make revised privacy practices apply to information we already maintain as well as information received in the future, to the extent permitted by law. A revised notice will identify its effective date, be available on TrancePlan.com, and be provided upon request.

We will promptly revise the notice when a material change requires it and provide or distribute the revision as required by law. You may request the current notice at any time using the contact details above.

Prepared using the HHS February 2026 model notice for health care providers, the HIPAA notice requirements in 45 CFR §164.520, and New York social-work confidentiality guidance. The description of current federal requirements also takes account of HHS guidance on the partial vacatur of the 2024 reproductive-health privacy rule.