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.
Effective date: September 3, 2026
Our responsibilities
Brave Space for Healing is required by law to maintain the privacy and security of your protected health information, provide this notice of our legal duties and privacy practices, follow the terms of the notice currently in effect, and notify you if a breach occurs that may have compromised the privacy or security of your information.
We reserve the right to change the terms of this notice. New notice terms may apply to all protected health information maintained by the practice. The current notice will be available upon request and, if applicable, posted on the practice website.
How we may use and disclose your health information
Treatment
We may use or share your health information to provide, coordinate, or manage your care. For example, we may use information from your intake, assessment, treatment plan, or progress notes to provide psychotherapy, consult with a supervisor, or coordinate with another provider when appropriate.
Payment
We may use and disclose your health information to bill and receive payment for services. This may include sharing diagnosis, dates of service, service codes, fees, and other information needed for billing, claims, payment, superbills, utilization review, or collections when applicable.
Health care operations
We may use and disclose your health information to run the practice, improve care, complete documentation, support supervision or consultation, conduct quality review, comply with legal or ethical requirements, manage business operations, and communicate with you about services.
Business associates and technology vendors
We may share protected health information with vendors or contractors that perform services for the practice, such as electronic health record systems, billing services, secure communication tools, telehealth platforms, documentation tools, accounting, or legal/consulting services. When required by HIPAA, we enter into Business Associate Agreements requiring them to appropriately safeguard protected health information.
Supervision and consultation
Because services may be provided under clinical supervision, your information may be discussed with an approved supervisor or professional consultant for treatment, supervision, ethics, documentation, risk assessment, and quality of care. Identifying details are limited when possible.
Required or permitted by law
We may use or disclose your information when required or permitted by federal, state, or local law. This may include reporting suspected abuse or neglect, responding to court orders, assisting with serious safety concerns, reporting certain injuries or threats, complying with health oversight activities, or responding to legal/ethical proceedings.
Safety and emergencies
We may disclose information if necessary to prevent or lessen a serious and imminent threat to your health or safety or the health or safety of another person. We may also disclose information to emergency contacts, crisis responders, emergency services, or health care providers as clinically and legally appropriate.
Workers' compensation, public health, and government functions
We may disclose information as allowed or required for workers' compensation, public health activities, health oversight, law enforcement, national security, military/veterans matters, correctional institutions, medical examiners, coroners, or other specialized government functions when applicable.
Research
Brave Space for Healing does not currently use client protected health information for research. If this practice changes, any research use or disclosure will comply with applicable law and will require your authorization when required.
Marketing and sale of information
We will not sell your protected health information. We will not use your information for marketing that requires authorization unless you provide written authorization.
Fundraising
Brave Space for Healing does not use or disclose your protected health information for fundraising activities.
Psychotherapy notes
If I create psychotherapy notes as defined by law, they are maintained separately from the general clinical record and receive additional privacy protections. Most uses and disclosures of psychotherapy notes require your specific written authorization, except in limited circumstances permitted or required by applicable state or federal law.
Special Protections for Substance Use Disorder Records
To the extent Brave Space for Healing creates, maintains, or receives substance use disorder patient records that are protected by 42 CFR Part 2, those records receive additional federal confidentiality protections.
Part 2 records generally may not be used or disclosed in a civil, criminal, administrative, or legislative investigation or proceeding against you unless you provide specific written consent or the disclosure is authorized by a court order and subpoena that meet the requirements of federal law.
Uses and disclosures of Part 2 records will be handled in accordance with HIPAA, 42 CFR Part 2, and other applicable law.
Additional Washington Privacy Protections
Washington law provides additional confidentiality protections for certain health information, including mental health treatment records and information related to sexually transmitted infections. When Washington law provides greater privacy protection than federal law, Brave Space for Healing will follow the more protective law.
Mental health treatment information generally will not be disclosed without your authorization except when disclosure is permitted or required by Washington law. Information related to sexually transmitted infection testing or treatment is also subject to additional restrictions on disclosure and redisclosure under Washington law.
Uses and disclosures requiring your written authorization
We will obtain your written authorization before using or disclosing your health information for purposes not otherwise permitted by law. You may revoke an authorization in writing at any time, except to the extent we have already relied on it.
Written authorization is generally required for most disclosures to attorneys, employers, schools, family members, partners, or other third parties unless another legal permission or requirement applies.
Your rights
Request access to your records
You may request to inspect or receive an electronic or paper copy of health information maintained in your designated record set. We will respond within the time required by applicable law. Under Washington law, requests generally must be addressed no later than 15 working days, subject to limited circumstances in which additional time is permitted.
Certain information may be excluded from the right of access as permitted by law, including separately maintained psychotherapy notes and information prepared for certain legal proceedings.
Request an amendment
You may ask us in writing to correct or amend health information you believe is inaccurate or incomplete. We will respond within the time required by law. If your request is denied, you may submit a written statement of disagreement as permitted by law.
Request confidential communications
You may ask us to contact you in a specific way or at a specific location. We will accommodate reasonable requests.
Choose Someone to Act for You
If you have given someone legal authority to make health care decisions for you, or if someone is otherwise legally authorized to act as your personal representative, that person may exercise your privacy rights to the extent permitted by law. We will verify that the person has appropriate authority before taking action.
Request restrictions
You may request limits on how we use or disclose your information for treatment, payment, or operations. We are not required to agree to all requested restrictions, except in certain situations involving services paid in full out of pocket when you ask that information not be shared with a health plan for payment or operations.
Accounting of disclosures
You may request a list of certain disclosures of your health information. The list will not include all disclosures, such as those made for treatment, payment, health care operations, or disclosures you authorized.
Your Choices
In some circumstances, you may tell us whether and how you want information shared with family members, close friends, or others involved in your care or payment for your care.
If you are unable to express a preference, we may use professional judgment and disclose limited information when permitted by law and when we believe doing so is in your best interest or necessary for your safety.
Washington law may place additional restrictions on disclosures of mental health or other specially protected information.
Copy of this notice
You may request a paper or electronic copy of this notice at any time, even if you previously agreed to receive it electronically.
File a complaint
You may file a complaint if you believe your privacy rights have been violated. You may complain directly to Brave Space for Healing or to the U.S. Department of Health and Human Services Office for Civil Rights. You will not be retaliated against for filing a complaint.
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Website: HHS Office for Civil Rights HIPAA Complaint Portal
How to contact us
For questions about this notice, privacy practices, or your health information rights, contact:
Rhoni Figueroa, Privacy Contact
Brave Space for Healing
Phone: 425-598-0955
Email: rhoni@bravespaceforhealing.com