HIPPA Notice of Privacy Practices
Effective Date: 07/14/2026
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.
Our Responsibilities
- Maintain the privacy and security of your protected health information.
- Provide you with this Notice of our legal duties and privacy practices.
- Follow the terms of the Notice currently in effect.
- Notify you if a breach occurs that may have compromised the privacy or security of your information.
- Not use or share your information other than as described here unless you authorize us in writing.
Your Rights
- Get an electronic or paper copy of your medical record: You may ask to see or receive a copy of your medical record. We will respond as required by law and may charge a reasonable cost-based fee where permitted.
- Ask us to correct your medical record: You may ask us to correct health information that you believe is incorrect or incomplete. We may deny the request in certain circumstances, but we will explain why in writing.
- Request confidential communications: You may ask us to contact you in a specific way or at a specific address.
- Ask us to limit what we use or share: You may ask us not to use or share certain health information for treatment, payment, or healthcare operations. We are not always required to agree, except where required by law.
- Get a list of those with whom we have shared information: You may ask for an accounting of certain disclosures.
- Get a copy of this Notice: You may request a paper copy of this Notice at any time.
- Choose someone to act for you: If you have given someone medical power of attorney or if someone is your legal guardian, that person may exercise your rights as permitted by law.
- File a complaint: You may complain to Ethos Clinic or to the U.S. Department of Health and Human Services Office for Civil Rights if you believe your privacy rights have been violated. We will not retaliate against you for filing a complaint.
How We May Use and Disclose Your Information
- Treatment: We may use and share your health information with professionals involved in your care.
- Payment: We may use and share health information to bill and receive payment from health plans or other entities.
- Healthcare operations: We may use and share health information to run our practice, improve care, train staff, conduct quality review, and manage services.
- Appointment reminders and communications: We may contact you about appointments, treatment options, services, and administrative matters.
- Business associates: We may share information with vendors who perform services for us and who are required to safeguard protected health information.
- Required by law: We may use or share information when required by federal, state, or local law.
- Public health and safety: We may disclose information for public health activities, abuse or neglect reporting, serious threats to health or safety, or other circumstances permitted or required by law.
- Health oversight activities: We may disclose information to agencies authorized for audits, investigations, inspections, licensing, and other oversight activities.
- Legal proceedings: We may disclose information in response to a court or administrative order, subpoena, discovery request, or other lawful process when applicable requirements are met.
- Law enforcement: We may disclose information for law enforcement purposes only as permitted or required by applicable law.
- Workers compensation: We may disclose information as authorized by workers compensation laws or similar programs.
- Coroners, medical examiners, and funeral directors: We may disclose information as permitted or required by law.
- Research: We may use or share information for approved research when legal requirements are met.
Uses and Disclosures Requiring Written Authorization
- Most uses and disclosures of psychotherapy notes, if maintained separately as defined by HIPAA.
- Ethos Clinic Website Compliance Packet – Draft for review
- Most uses and disclosures for marketing purposes.
- Sale of protected health information.
- Other uses and disclosures not described in this Notice.
- You may revoke an authorization in writing at any time, except to the extent we have already relied on it.
- Behavioral Health, Substance Use, and Sensitive Information
- Behavioral health, substance use disorder, HIV-related, genetic, minor consent, and other sensitive records may receive additional protections under federal or Pennsylvania law. Ethos Clinic will follow applicable heightened confidentiality rules when they apply.
Minimum Necessary
When using, disclosing, or requesting protected health information, Ethos Clinic makes reasonable efforts to limit information to the minimum necessary to accomplish the intended purpose, except where the minimum necessary standard does not apply, such as disclosures for treatment.
Privacy Officer and Complaints
Privacy Officer: Ayesha Abbasi, Practice Manager
Ethos Clinic
Website: www.ethosclinic.com
Phone: Emmaus- 484-232-5288 Lehighton- 610-900-4234
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. Ethos Clinic will not retaliate against you for filing a complaint.
Changes to This Notice
We may change the terms of this Notice and the changes will apply to all information we maintain. The current Notice will be posted on our website and available upon request.