Notice of Privacy Practices
| Practice Name | After Hours Psychiatry Care |
|---|---|
| Legal Entity | WALK IN FAMILY PSYCHIATRY LLC |
| Effective Date | 04/01/2026 |
| Mailing Address | 2013 Live Oak Blvd. Ste A. Saint Cloud, Florida 34771 |
| Privacy Contact | Michelie Levrier APRN PMHNP-BC FNP-BC | info@afterhourspsych.com | (407) 674-9332 |
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.
After Hours Psychiatry Care (the "Practice," "we," "us," or "our") understands the importance of keeping your medical information private. This Notice of Privacy Practices describes how we may use and disclose your protected health information, your rights, and our legal duties. This notice applies to the records and information we create or maintain in connection with the services we provide.
1. Your Rights
You have the following rights regarding your protected health information, subject to applicable law:
Get a copy of your medical record.
You may ask to inspect or obtain a paper or electronic copy of your medical record and certain other health information we maintain. We may charge a reasonable, cost-based fee where permitted.
Ask us to correct your record.
You may request that we amend health information you believe is incorrect or incomplete. We may deny a request in some circumstances, but if we do, we will explain why in writing when required.
Request confidential communications.
You may ask us to contact you in a specific way, such as only at a certain phone number, email address, mailing address, or through another reasonable method. We will accommodate reasonable requests as required by law.
Ask us to limit what we use or share.
You may ask us not to use or disclose certain information for treatment, payment, or health care operations, or not to disclose information to certain family members or others involved in your care. We are not always required to agree, but we will consider each request and must agree in limited situations required by law.
Get a list of disclosures.
You may request an accounting of certain disclosures of your protected health information that we made outside treatment, payment, and health care operations and outside certain other exceptions.
Get a copy of this notice.
You may request a paper copy of this notice at any time, even if you previously agreed to receive it electronically.
Choose someone to act for you.
If you have given someone medical power of attorney, if someone is your legal guardian, legal custodian, or if another person is otherwise legally authorized to act for you, we will recognize that person to the extent allowed by law. For minor patients, a parent or guardian may have rights and access as permitted by applicable law.
File a complaint.
You may complain to us if you believe your privacy rights have been violated. You may also complain to the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.
2. Your Choices
For certain uses and disclosures, you have choices or we will ask for your permission. For example:
• We may share information with family members, friends, guardians, caregivers, or others involved in your care or payment for care if you agree, do not object, or if the law otherwise allows us to do so.
• We may contact you about appointments, follow-up care, service changes, billing matters, treatment alternatives, or health-related benefits and services.
• We may use or disclose your information for marketing, the sale of information, fundraising, the recording of certain visits or interactions, or most other purposes not described in this notice only with your written authorization, unless the law allows or requires a different approach.
• If you give us written permission, you may revoke it later in writing, except to the extent we have already acted in reliance on it.
3. How We Commonly Use and Disclose Information
Treatment
We may use and disclose your information to provide, coordinate, or manage your care. Example: we may share information with other health care professionals, pharmacies, laboratories, hospitals, telehealth platforms, caregivers, or referral sources involved in your treatment.
Payment
We may use and disclose your information to bill and receive payment for services. Example: we may send billing information to you, a responsible payor, or a payment service provider, or we may use business associates to support payment processing and collections.
Health Care Operations
We may use and disclose your information to operate our practice, improve quality, train staff, manage risk, audit records, review recordings where used, support compliance activities, conduct peer review, and maintain business functions.
Appointment and Service Communications
We may contact you by phone, text, email, mail, or other reasonable means regarding appointments, scheduling, follow-up, intake, treatment, billing, reminders, and service-related messages. We use reasonable safeguards, but electronic communications can involve privacy risks.
Business Associates and Vendors
We may disclose information to service providers that help us operate our practice, such as telehealth platforms, communications vendors, cloud storage providers, call or form tracking vendors, consultants, attorneys, accountants, and payment processors, when those providers are permitted to receive the information and are subject to appropriate contractual or legal obligations.
4. Other Uses and Disclosures Permitted or Required by Law
We may use or disclose your information without your written authorization in additional situations permitted or required by law, such as the following:
• To report abuse, neglect, domestic violence, or threats to health or safety when reporting is permitted or required by law.
• For public health activities, health oversight, licensing, audits, inspections, and investigations.
• To comply with court orders, subpoenas, warrants, or other lawful process, or to respond to law enforcement requests when legally permitted.
• For workers’ compensation, disability evaluations, national security, military, correctional, or similar government functions when authorized by law.
• For research, coroners, medical examiners, funeral directors, or organ and tissue donation organizations when the law permits those disclosures.
• To prevent or lessen a serious and imminent threat to health or safety, or in certain emergency circumstances.
5. Special Protections for Mental Health Information, Psychotherapy Notes, and Certain SUD Records
Because we provide psychiatric and behavioral health-related services, some information we maintain may receive heightened protection. Most uses and disclosures of psychotherapy notes, if we maintain them, require your written authorization except in limited circumstances allowed by law.
If we create, receive, maintain, or transmit records subject to the federal confidentiality rules for substance use disorder patient records under 42 U.S.C. 290dd-2 and 42 CFR Part 2, those records will be handled in accordance with the additional protections required by those laws. In that event, additional restrictions may apply to uses, disclosures, redisclosures, complaints, fundraising, and the use of those records in civil, criminal, administrative, or legislative proceedings. This section is intended to preserve compliance flexibility; you should remove or tailor it with counsel if Part 2 does not apply to your practice.
For minor patients, a parent, legal guardian, guardian advocate, legal custodian, or other authorized representative may have certain rights to receive information or act on the patient’s behalf to the extent allowed by law. In some circumstances, confidentiality rights may belong partly or entirely to the minor patient. We will apply the rules that govern the specific situation.
6. Our Responsibilities
• We are required by law to maintain the privacy and security of protected health information.
• We will provide you with this notice of our legal duties and privacy practices, and we will follow the terms of the notice currently in effect.
• We will notify affected individuals following a breach of unsecured protected health information when required by law.
• We will revise this notice when our privacy practices materially change and will post the revised notice on our website and make it available on request.
• We may ask you to acknowledge receipt of this notice, but your refusal to sign an acknowledgment will not prevent us from using or disclosing information as otherwise permitted by law.
7. Questions and Complaints
If you have questions about this notice, want to exercise a right, or want to file a complaint with us, contact Michelie Levrier APRN PMHNP-BC FNP-BC at 2013 Live Oak Blvd. Ste A. Saint Cloud, Florida 34771, info@afterhourspsych.com, or (407) 674-9332.
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. OCR accepts complaints online, by mail, or by email. OCR may be reached at 1-800-368-1019 (TDD 1-800-537-7697).