# Notice of Privacy Practices - Link: https://www.alquimedez.com/notice-of-privacy-practices - Published: 2026-10-22T01:19:25+00:00 - Author: alquimedezhemo [Leer este aviso en español](https://www.alquimedez.com/aviso-de-practicas-de-privacidad) ALQUIMEDEZ MENTAL HEALTH COUNSELING Arizona • Connecticut • Florida • Indiana • New Jersey • New York • Pennsylvania• Puerto Rico Effective date: October 21, 2026 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. ## Who this notice covers This notice applies to health information held by Alquimedez Mental Health Counseling and to its workforce members providing or supporting our services. It covers paper, electronic, and spoken information, including information used for telehealth, counseling, psychiatric services, medication management, evaluations, billing, and care coordination. Independent providers may give you their own notices. The jurisdiction provisions in this notice apply when the law of that jurisdiction governs your care or records. Including a jurisdiction here does not establish a provider’s license or guarantee that a particular service is available there. ## Questions and privacy requests Contact: Pat Morel, Privacy Officer, Alquimedez Mental Health Counseling Telephone: 315-505-2400Email: info@alquimedez.com — ask that your message be directed to the Privacy Officer.Website: https://www.alquimedez.com You may call for help making a request, submitting a complaint, or obtaining a secure way to send documents. Avoid sending detailed health information through ordinary email or public website forms. You may request this notice on paper or electronically and ask us to explain it in a language or format you understand. ## Our responsibilities We must protect the privacy of your protected health information, provide this notice of our legal duties and privacy practices, and follow the notice currently in effect. We must notify you of a breach of your unsecured protected health information as required by law. We use safeguards and limit access to authorized people. When the minimum-necessary rule applies, we limit information to what is reasonably needed for the purpose. HIPAA is a federal privacy standard. When another applicable law gives your information greater protection or gives you greater access rights, we follow that law. The permissions described below do not override stricter counseling, mental-health, substance-use, HIV-related, genetic-information, or minor-consent laws. ## 1. How we use and share information We use or share information for the purposes below only when the applicable law permits it. We obtain written authorization or consent first when required by the special protections and jurisdiction provisions in this notice. ### Treatment We may use information to evaluate you, provide services, prescribe medication, and coordinate care. For example, your therapist and psychiatric prescriber may discuss symptoms and medications to coordinate your treatment. We may communicate with another treating provider when permitted, obtaining any legally required consent first. ### Payment We may use information to verify benefits, request authorization for services, submit claims, and collect payment. For example, a claim may include your diagnosis, date of service, and procedure code. This permission is subject to special confidentiality rules and your right to restrict disclosures to a health plan for services paid in full out of pocket. ### Health care operations We may use information to manage our practice, review quality, supervise staff, coordinate administrative work, and evaluate our services. For example, authorized clinical supervisors may review records to assess quality of care, subject to applicable confidentiality requirements. ### Service providers and electronic systems Authorized service providers may help with records, telehealth, billing, scheduling, or technology. When required, we use written business associate agreements or other confidentiality agreements. These arrangements do not authorize unrestricted access or independent advertising use of your information. ### Appointment reminders and care communications We may contact you about appointments, follow-up care, treatment options, or health- related services relevant to your care. Tell us which telephone number, address, or communication method is safe. Electronic messages can be seen by others who have access to your device or account; you may request an alternative. ### Family, friends, and others involved in your care When permitted by applicable law, we may share information directly relevant to a person’s involvement in your care or payment if you agree, have an opportunity to object and do not object, or we can reasonably infer your agreement. If you cannot express your preference, we may use professional judgment to make a limited disclosure in your best interest. We may also make permitted disclosures for disaster relief. We obtain written permission instead whenever stricter law requires it. ### Minors and personal representatives We verify the authority of a parent, guardian, health care agent, or other personal representative before allowing access or decisions about your information. A parent does not automatically have access to every minor’s record. Minor-consent laws, court orders, and abuse, neglect, or endangerment concerns may limit that authority. The age and service involved affect these rights; we apply the relevant jurisdiction’s requirements. ## 2. Other legally permitted disclosures Each category below is subject to legal conditions. We do not release records merely because someone asks or presents a subpoena. Additional mental-health privileges, authorization requirements, and Part 2 restrictions may prohibit a disclosure that HIPAA would otherwise allow. ### Public health, safety, and reporting We may disclose information to authorized public health authorities for matters such as reportable disease, adverse medication reactions, and product recalls. We may report suspected child abuse or neglect, abuse of a vulnerable adult, or domestic violence when the law requires or permits it and its conditions are met. We may make legally permitted disclosures to prevent or reduce a serious and imminent threat, and comply with applicable duties to protect or warn. ### Oversight and legal requirements We may provide information for authorized audits, licensing reviews, inspections, investigations, and other health oversight activities. We must provide information to the U.S. Department of Health and Human Services when required to review privacy compliance. A disclosure required by law is limited to the scope of that requirement and remains subject to other controlling confidentiality laws. ### Courts, administrative proceedings, and law enforcement We may respond to a valid court or administrative order, or another lawful process, only after required safeguards are satisfied. Some records require your specific consent or a special court order. We may make limited disclosures for legally permitted law-enforcement purposes. Court involvement, a custody dispute, a lawyer’s request, or an employer referral does not by itself remove your confidentiality rights. Part 2 records have the additional protections in section 3 below. ### Research Health information may be used for research with your written authorization, or without it only when applicable legal safeguards and any required review or waiver are satisfied. More protective rules for mental-health and substance-use records still apply. ### Other limited purposes When authorized by applicable law, we may disclose information for workers’ compensation; to coroners, medical examiners, or funeral directors; for organ or tissue donation; and for specified military, national-security, protective-service, or correctional purposes. These categories do not create a general right to inspect your counseling or substance-use records. ### Written authorization and your right to revoke it Uses or disclosures not described in this notice require your written authorization. Marketing and sales of protected health information that require authorization under HIPAA will not occur without it. Most uses or disclosures of separately maintained psychotherapy notes also require a specific authorization; narrow legal exceptions apply. Routine progress notes, medication lists, diagnoses, and treatment plans are not automatically psychotherapy notes under HIPAA. You may revoke an authorization in writing through our Privacy Officer. Revocation stops future reliance on that authorization, but does not undo action already taken in reliance on it. Other limited legal exceptions may apply. Signing an acknowledgment of this notice is not an authorization to release records. ## 3. Substance-use records and special choices ### Records protected by 42 CFR Part 2 Certain records identifying a person as having or having had a substance use disorder are protected by 42 CFR Part 2. This includes qualifying records we receive from a federally assisted substance-use program. A substance-use diagnosis alone does not necessarily make every record a Part 2 record. Alquimedez receives protected substance-use records from other programs; it does not operate as a Part 2 program. For Part 2 records, we obtain the consent required by Part 2 unless a specific exception permits disclosure. You may give a single consent for future treatment, payment, and health care operations. For example, a valid consent may allow a substance-use program to share records with our treating clinicians and allow billing information to be shared with your insurer. You may ask for restrictions and revoke consent in writing, subject to prior reliance and any special rules for criminal-justice referral consents. When Part 2 records are disclosed under your treatment, payment, and operations consent to a HIPAA covered entity or its business associate, the recipient may redisclose them as HIPAA permits, subject to Part 2’s restrictions on proceedings against you and any stricter applicable law. Other recipients remain subject to the restrictions that apply to them. Information disclosed under HIPAA may otherwise be redisclosed by a recipient and may no longer be protected by HIPAA; other confidentiality laws may still protect it. ### Investigations and proceedings against you Part 2 records, and testimony describing their contents, may not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you without your specific written consent or a court order meeting Part 2 requirements. Required notice and an opportunity to be heard must be provided to you or the record holder. A qualifying court order must be accompanied by a subpoena or comparable legal mandate compelling disclosure. A routine subpoena alone is insufficient. A consent for proceedings against you cannot be combined with a consent for another purpose. ### Narrow exceptions and separate notes Part 2 permits specific disclosures without patient consent under defined conditions, such as to medical personnel for a bona fide medical emergency, qualified research or audit activities, certain internal program communications or qualified service organizations, reports of suspected child abuse or neglect, and limited reports of crimes or threats on program premises or against program personnel. Public-health disclosures under Part 2 must meet its de-identification requirements. Reporting an incident does not authorize release of the underlying treatment record for an investigation against you. We apply the specific exception and any stricter law before disclosure. Separately maintained substance-use counseling notes, when protected by Part 2, generally require a separate consent and cannot be included in a broad treatment, payment, and operations consent, except as the law permits. ### Fundraising and other optional communications If we contact you for legally permitted fundraising, you can opt out using the instructions in the communication or by contacting the Privacy Officer. If Part 2 records would be used, we must first give you a clear opportunity to elect not to receive the communication. Your decision will not affect your treatment or payment. A privacy- notice acknowledgment does not enroll you in marketing or authorize recording a session. ## 4. Your rights and how to use them Contact the Privacy Officer at 315-505-2400 or info@alquimedez.com to exercise these rights. We may ask for a written request and reasonable identity verification. We will help you understand the process; a request for records is separate from a request for treatment. ### Inspect or obtain your records You may inspect or obtain a paper or electronic copy of information in the designated record set, including medical and billing records used to make decisions about you. We provide the requested format when readily producible, or an agreed alternative. We act within 30 days, or sooner when applicable law requires. HIPAA permits one additional 30-day extension with timely written reasons and a completion date. Only legally permitted, reasonable cost-based fees apply; we will explain any fee in advance. Limited exceptions apply, including separately maintained psychotherapy notes and certain materials prepared for legal proceedings. A denial must have a lawful basis. We explain it in writing, identify any right to an independent review, and explain how to complain. We do not withhold access merely because you owe a treatment bill. We provide a summary instead of copies only if you agree. ### Request a correction You may ask us in writing to amend inaccurate or incomplete information and explain why. We generally act within 60 days. A permitted extension of up to 30 additional days requires written notice. If we deny the request, we explain the reason and your right to submit a statement of disagreement. An amendment does not erase the original record. ### Request confidential communications You may ask us to contact you in a specific way or at another location, such as using a private telephone number or alternate address. We accommodate reasonable requests and do not require you to explain why. Tell us whether messages may identify the practice or discuss your care. ### Ask us to restrict uses or disclosures You may request limits on information used or shared for treatment, payment, operations, or with people involved in your care. We are generally not required to agree, but will follow an accepted restriction subject to legal exceptions, such as emergency treatment. We must honor a request not to disclose information to your health plan for payment or operations when the information relates solely to a service paid in full out of pocket by you or someone other than the plan, unless disclosure is required by law. Tell us before we submit the claim. ### Obtain an accounting of disclosures You may request an accounting of disclosures covered by HIPAA for up to the preceding six years. It generally excludes treatment, payment, operations, authorized disclosures, and other legal exceptions. We respond within 60 days, with one permitted 30-day extension on written notice. The first accounting in a 12-month period is free; we explain any permitted charge for additional requests and allow you to modify or withdraw the request. Additional Part 2 accounting or intermediary-disclosure rights apply when legally effective and applicable; ask our Privacy Officer for help. ### Receive this notice, use a representative, or complain You may obtain a free paper copy even if you accepted an electronic copy, receive an explanation, act through a legally authorized representative, and file a complaint without retaliation. Instructions appear on section 6 below. ## 5. State and Puerto Rico protections These provisions apply within each law’s scope. We obtain legally required permission; HIPAA permissions do not override professional confidentiality privileges. ### Arizona Communications with licensed behavioral-health professionals are privileged under A.R.S. § 32-3283. We do not disclose protected communications without a valid waiver or a statutory exception. A.R.S. § 36-509 also governs covered mental-health records, allowing only authorized disclosures. Applicable reporting, board-investigation, and other legal exceptions remain in effect. ### Connecticut Professional-counselor communications are protected under Conn. Gen. Stat. § 52- 146s. Disclosure generally requires written consent unless a specified exception applies, such as a mandated report or a qualifying safety concern. Psychiatric communications may have additional protection under §§ 52-146d–52-146f. We do not assume that HIPAA’s treatment or payment permission alone authorizes a disclosure protected by these statutes. ### Florida Fla. Stat. § 491.0147 protects communications with covered counseling professionals. We obtain written permission unless a statutory exception applies, including specified safety or reporting circumstances. Where a family receives therapy, required permissions from the participating family members must be obtained. Records within § 394.4615 are also subject to its clinical-record protections. ### Indiana Indiana Code 16-39-2 protects mental-health records. Disclosure requires consent unless an applicable statutory exception authorizes it. We also follow applicable access rights, court-disclosure procedures, and professional privileges. A third- party request alone does not authorize release. ### New Jersey N.J.A.C. 13:34-18 protects professional-counseling records and communications. Disclosure generally requires written permission or a specified legal exception. For family counseling, we obtain each legally required family-member waiver before releasing protected family information. Special rules govern minors and access; confidentiality continues after a client’s death. ### New York We follow professional confidentiality and access requirements. Mental Hygiene Law§§ 33.13 and 33.16 apply to records and providers within their statutory scope; they do not automatically govern every private practice. Public Health Law Article 27- F provides special protection for confidential HIV-related information, including limits on redisclosure and specific authorization requirements unless an exception applies. ### Pennsylvania Where applicable, the Mental Health Procedures Act, including 50 P.S. § 7111, protects treatment records and permits specified disclosures, including qualifying HIPAA disclosures under its 2022 amendment. Separate professional privileges and drug- and-alcohol confidentiality requirements may still apply. We assess those protections before releasing information. ### Puerto Rico Law 408-2000, as amended, protects mental-health information and restricts unauthorized disclosure and redisclosure. We obtain express authorization where required, including for covered fax transmissions, and provide applicable confidentiality warnings to recipients. We explain confidentiality rights verbally and in writing at the initial evaluation or as soon as required by law. Confidentiality violations may constitute a crime. Minor-record access is subject to Law 408’s specific limits, including additional consent or court requirements for information beyond the categories parents may inspect. ## 6. Complaints, notice changes, and receipt ### Complain directly to Alquimedez If you believe we violated your privacy rights, contact our Privacy Officer at 315- 505-2400 or info@alquimedez.com. Ask for a secure way to provide a written complaint or supporting documents. Describe what happened, when it happened, and how we can safely contact you. You may ask for help preparing the complaint. We will not retaliate against you, deny care as punishment, or require you to waive your complaint rights. ### Complain to the federal government You may complain directly to the U.S. Department of Health and Human Services, Office for Civil Rights (OCR), including about HIPAA or Part 2. You do not have to complain to us first. Visit https://www.hhs.gov/hipaa/filing-a-complaint/index.html for the complaint portal and current filing instructions. For assistance, call 1-800-368- 1019; TDD: 1-800-537-7697. Mail may be addressed to Office for Civil Rights, U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Washington, DC 20201. OCR complaints generally must be filed within 180 days after you knew of the act or omission; OCR may extend that period for good cause. You may also complain to the appropriate state or Puerto Rico health, licensing, or patient-rights authority. For a possible criminal confidentiality violation in Puerto Rico, you may also report it to the appropriate law-enforcement authority. Ask our Privacy Officer for help identifying the relevant office; this does not limit your right to contact it directly. ### Changes to this notice We reserve the right to change our privacy practices and this notice as permitted by law and to apply the revised notice to information we already hold as well as information we receive later. The updated notice will state its effective date. You may obtain it on our website, from our office, or by contacting the Privacy Officer. We will provide any additional notice required by applicable law. ### Acknowledgment of receipt — separate from authorization I acknowledge that I received the Alquimedez Mental Health Counseling Notice of Privacy Practices identified below. I understand that this acknowledgment confirms receipt only. It does not authorize release of my records, waive confidentiality rights, consent to recording, or create a financial agreement. I may ask questions and request another copy. Notice effective date: October 21, 2026 Date received: ____________________ Patient name: __________________________________________________________Patient or authorized representative signature: _________________________________Representative name and legal authority, if applicable: _________________________________________________________________________________________________ ### Staff documentation if acknowledgment is not obtained Notice delivered by: __________________________ Date: _____________________ Method: Paper / Secure electronic delivery / Other: ______________________________Good-faith effort and reason acknowledgment was not obtained: __________________________________________________________________________________________Staff name/signature: _____________________________________________________ A patient’s refusal to sign this acknowledgment does not prevent provision of care. Retain documentation of notice delivery and good-faith efforts as required. For Puerto Rico, document the required verbal explanation and the language used.