NOTICE OF PRIVACY PRACTICES

I. Introduction

Inspired Consciousness LLC("we," "us," or "our") is committed to protecting the privacy of your health information. This Notice of Privacy Practices ("Notice") describes how we may use and disclose your protected health information ("PHI") to carry out treatment, payment, or health care operations, and for other purposes permitted or required by law. It also describes your rights regarding your health information and how you can exercise those rights.

We are required by law to maintain the privacy of your PHI, to provide you with notice of our legal duties and privacy practices concerning your PHI, and to notify you following a breach of unsecured PHI. We must follow the privacy practices described in this Notice while it is in effect. We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law. Any changes will apply to all PHI we maintain. Before we make a significant change in our practices, we will revise this Notice and make the new Notice available upon request.

You may request a copy of this Notice at any time. For more information about our privacy practices, or for additional copies of this Notice, please contact us using the information listed at the end of this Notice.

II. How We May Use and Disclose Your Protected Health Information

The following categories describe different ways that we may use and disclose your PHI. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

A. Uses and Disclosures Without Your Authorization

1. Treatment

We may use or disclose your PHI to provide, coordinate, or manage your health care and related services. This includes the coordination or management of your health care with a third party. For example, we may disclose your PHI to a specialist who is treating you, or to a pharmacist who is filling a prescription for you. We may also disclose PHI to other health care providers who may be treating you when necessary for your treatment.

2. Payment

We may use or disclose your PHI to obtain payment for services we provide to you. For example, we may contact your health insurer to certify that you are eligible for benefits, or we may provide your insurer with details regarding your treatment to determine if your insurer will cover your treatment. We may also use and disclose your PHI to obtain prior authorization from your health plan for treatment we recommend.

3. Health Care Operations

We may use or disclose your PHI for our health care operations. Health care operations include quality assessment and improvement activities, reviewing the competence or qualifications of health care professionals, conducting training programs, accreditation, certification, licensing or credentialing activities, and conducting or arranging for medical review, legal services, and auditing functions.

4. Required by Law

We may use or disclose your PHI when required to do so by federal, state, or local law. For example, we may disclose PHI when required by a court order in a litigation proceeding such as a malpractice action.

5. Public Health Activities

We may disclose your PHI to public health authorities for public health activities. These activities may include: preventing or controlling disease, injury, or disability; reporting births and deaths; reporting child abuse or neglect; reporting adverse reactions to medications or problems with products; notifying people of recalls of products they may be using; or notifying a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.

6. Victims of Abuse, Neglect, or Domestic Violence

We may disclose PHI to the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence and the patient agrees to the disclosure, or if the disclosure is required or authorized by law.

7. Health Oversight Activities

We may disclose your PHI to a health oversight agency for activities authorized by law. These oversight activities include audits, investigations, inspections, licensure, and similar activities that are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

8. Judicial and Administrative Proceedings

We may disclose your PHI in response to a court or administrative order, subpoena, discovery request, or other lawful process. We will make reasonable efforts to notify you of the request or to obtain an order protecting the information requested.

9. Law Enforcement

We may disclose PHI to law enforcement officials for law enforcement purposes as required by law, in compliance with a court order, subpoena, or administrative request, to identify or locate a suspect, fugitive, material witness, or missing person, or when the PHI is evidence of a crime that occurred on our premises.

10. Coroners, Medical Examiners, and Funeral Directors

We may release PHI to a coroner or medical examiner as necessary to identify a deceased person or to determine cause of death. We may also release PHI to funeral directors as necessary to carry out their duties.

11. Organ Donation

If you are an organ donor, we may release PHI to organizations that handle organ procurement or organ, eye, or tissue transplantation, or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.

12. Research

Under certain circumstances, we may use and disclose PHI about you for research purposes, provided the research has been specially approved by an authorized institutional review board or privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.

13. Serious Threat to Health or Safety

We may use or disclose your PHI when necessary to prevent a serious threat to your health and safety, or the health and safety of the public or another person. Any disclosure would be to someone able to help prevent the threat.

14. Military and Veterans

If you are a member of the armed forces, we may release PHI as required by military command authorities. We may also release PHI about foreign military personnel to the appropriate foreign military authority.

15. National Security and Intelligence

We may release PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

16. Protective Services

We may disclose PHI to authorized federal officials so they may provide protection to the President, other authorized persons, or foreign heads of state, or to conduct special investigations.

17. Workers' Compensation

We may disclose PHI as authorized to comply with workers' compensation laws and other similar legally established programs.

18. Inmates

If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release PHI to the correctional institution or law enforcement official if necessary for your health and safety, the health and safety of others, or the safety and security of the correctional institution.

B. Uses and Disclosures Requiring Your Written Authorization

For uses and disclosures not described above, we will ask for your written authorization before using or disclosing your PHI. You may revoke your authorization in writing at any time. If you revoke your authorization, we will no longer use or disclose your PHI for the purposes covered by the authorization, except where we have already relied on the authorization. The following uses and disclosures require your authorization:

• Most uses and disclosures of psychotherapy notes (if applicable)
• Uses and disclosures of PHI for marketing purposes
• Uses and disclosures that constitute a sale of PHI
• Other uses and disclosures not described in this Notice

III. Your Rights Regarding Your Protected Health Information

You have the following rights regarding PHI we maintain about you:

1. Right to Inspect and Copy

You have the right to inspect and obtain a copy of PHI that may be used to make decisions about your care. Usually, this includes medical and billing records. To inspect and copy PHI, you must submit your request in writing. We may charge a fee for the costs of copying, mailing, or other supplies associated with your request. We may deny your request in certain limited circumstances. If we deny your request, you may request a review of the denial.

2. Right to Amend

If you believe PHI we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as we maintain the information. To request an amendment, your request must be made in writing and submitted to our Privacy Officer. You must provide a reason that supports your request. We may deny your request if you ask us to amend information that was not created by us, is not part of the PHI kept by or for us, is not part of the information you would be permitted to inspect and copy, or is accurate and complete.

3. Right to an Accounting of Disclosures

You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of PHI about you for purposes other than treatment, payment, health care operations, or as authorized by you. To request this list, you must submit your request in writing. Your request must state a time period, which may not be longer than six years. The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list.

4. Right to Request Restrictions

You have the right to request a restriction or limitation on the PHI we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the PHI we disclose about you to someone who is involved in your care or the payment for your care. We are not required to agree to your request unless you are asking us to restrict the disclosure of PHI to a health plan for payment or health care operations purposes and the PHI pertains solely to a health care item or service for which you, or a person on your behalf, has paid in full out of pocket. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.

5. Right to Request Confidential Communications

You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we contact you only at work or by mail. To request confidential communications, you must make your request in writing. We will accommodate all reasonable requests.

6. Right to a Paper Copy of This Notice

You have the right to a paper copy of this Notice. You may ask us to give you a copy of this Notice at any time. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy.

7. Right to Receive Notification of a Breach

You have the right to be notified in the event of a breach of your unsecured PHI. We will notify you as required by law.

IV. Our Duties

We are required by law to:

• Maintain the privacy of your PHI
• Provide you with notice of our legal duties and privacy practices with respect to PHI
• Notify you following a breach of unsecured PHI
• Follow the terms of the Notice that is currently in effect

V. Filing a Complaint

If you believe your privacy rights have been violated, you may file a complaint with our organization or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with our organization, contact our Privacy Officer using the contact information below. All complaints must be submitted in writing.

To file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights, send a letter to:

Or call 1-877-696-6775, or visit www.hhs.gov/hipaa/filing-a-complaint.

You will not be retaliated against for filing a complaint.

VI. Contact Information

For questions about this Notice, to exercise your rights, or to file a complaint, please contact:

Acknowledgment of Receipt

By scheduling an appointment or receiving services from Inspired Consciousness LLC, you acknowledge that you have been provided access to this Notice of Privacy Practices and understand how your protected health information may be used and disclosed. You may request a paper copy of this Notice at any time.