Legal · HIPAA

Notice of Privacy Practices

Last updated: August 7, 2026

This is a draft template based on the standard HHS Notice of Privacy Practices structure required under HIPAA. It is not legal advice and must be reviewed, completed, and finalized by a licensed attorney or compliance professional familiar with LM Behavioral Health’s specific practices before use with actual patients.

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 Commitment to Your Privacy

LM Behavioral Health is required by law to maintain the privacy of your protected health information (“PHI”), to provide you with this Notice of our legal duties and privacy practices, and to abide by the terms of the Notice currently in effect.

How We May Use and Disclose Your Health Information

Treatment

We may use and disclose your PHI to provide, coordinate, or manage your psychiatric care, including consultation with other healthcare providers involved in your treatment when appropriate and permitted.

Payment

We may use and disclose your PHI to obtain payment for services, including billing and communicating with your health insurance plan.

Healthcare Operations

We may use and disclose your PHI for our internal operations, such as quality assessment, compliance, and training.

Other Permitted or Required Uses

As required by law.
To avert a serious threat to health or safety.
For public health and safety activities.
To a health oversight agency for activities authorized by law.
In response to a court or administrative order, or a valid subpoena.
To coroners, medical examiners, or funeral directors as authorized by law.
For workers’ compensation purposes, as authorized by law.

Any other use or disclosure of your PHI will only be made with your written authorization, which you may revoke at any time in writing.

Your Rights Regarding Your Health Information

Right to Access — You have the right to inspect and obtain a copy of your health information.
Right to Amend — You have the right to request an amendment to your health information if you believe it is incorrect or incomplete.
Right to an Accounting of Disclosures — You have the right to request a list of certain disclosures we have made of your PHI.
Right to Request Restrictions — You have the right to request restrictions on certain uses and disclosures of your PHI.
Right to Request Confidential Communications — You have the right to request that we communicate with you in a certain way or at a certain location.
Right to a Paper Copy — You have the right to receive a paper copy of this Notice at any time, even if you agreed to receive it electronically.
Right to File a Complaint — If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

Telehealth

Care may be provided via telehealth (secure video visits). The same privacy and security protections that apply to in-person care apply to telehealth services.

Changes to This Notice

We reserve the right to change this Notice and to make the revised Notice effective for health information we already have as well as any information we receive in the future.

Contact Information / Privacy Officer

If you have questions about this Notice or would like to exercise any of the rights described above, please contact our Privacy Officer through our Contact page.

Effective date: August 7, 2026