Notice of Privacy Practices (HIPAA)

Effective date: September 22, 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.

InnerCalm Wellness Recovery provides substance use disorder treatment services at 89-31 161st St, Suite 402, Jamaica, NY 11432. We are required by law to maintain the privacy and security of your protected health information (PHI), to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect. Because we provide substance use disorder treatment, your records also receive additional federal protections described below.

Added protection for substance use disorder records (42 CFR Part 2)

Records of your identity, diagnosis, prognosis, or treatment in our substance use disorder program are protected by federal law and regulations (42 U.S.C. § 290dd-2; 42 CFR Part 2) in addition to HIPAA. In general, we may not tell a person outside the program that you attend it, or disclose any information identifying you as a person with a substance use disorder, unless:

• You consent in writing;
• The disclosure is allowed by a court order entered under the special requirements of Part 2;
• The disclosure is made to medical personnel in a genuine medical emergency;
• The disclosure is to qualified personnel for research, audit, or program evaluation; or
• You commit or threaten to commit a crime on program premises or against program personnel.

Federal law and regulations do not protect information about suspected child abuse or neglect from being reported under state law to appropriate authorities. Violation of these federal laws and regulations by a program is a crime, and suspected violations may be reported to the appropriate authorities in accordance with federal regulations.

Your rights

When it comes to your health information, you have the right to:

• Get a copy of your medical record. Ask us in writing; we will provide a copy or summary, usually within 30 days. We may charge a reasonable, cost-based fee.
• Ask us to correct your record. If you believe information in your record is incorrect or incomplete, you can ask us in writing to amend it. We may say no, but we will tell you why in writing within 60 days.
• Request confidential communications. You can ask us to contact you in a specific way (for example, only by cell phone) or at a specific address. We will accommodate all reasonable requests.
• Ask us to limit what we use or share. You can ask us not to use or share certain information for treatment, payment, or operations. We are not required to agree, except: if you pay for a service in full out of pocket, you can ask us not to share that information with your health insurer for payment or operations purposes, and we will honor that request unless a law requires the disclosure.
• Get a list of those with whom we've shared your information. You can ask for an accounting of disclosures for the six years prior to your request (excluding disclosures for treatment, payment, operations, and certain others). One accounting per year is free.
• Get a copy of this notice. You may ask for a paper copy at any time, even if you agreed to receive it electronically.
• Choose someone to act for you. A person with medical power of attorney or a legal guardian can exercise your rights and make choices about your health information.
• File a complaint if you feel your rights are violated. You may complain to us using the contact information at the end of this notice, or to the U.S. Department of Health and Human Services Office for Civil Rights, 200 Independence Avenue SW, Washington, DC 20201, 1-877-696-6775, or online at hhs.gov/hipaa/filing-a-complaint. Complaints regarding substance use disorder records may also be reported as provided under 42 CFR Part 2. We will not retaliate against you for filing a complaint.

Your choices

For certain health information, you can tell us your choices about what we share — for example, with your family, close friends, or others involved in your care. For substance use disorder records, sharing with family members or others generally requires your written consent, as described above.

We never sell your information, use or share it for marketing purposes, or share psychotherapy notes without your written authorization, except where the law permits or requires it.

Our uses and disclosures

Subject to the Part 2 protections above, we typically use or share your health information in the following ways:

• To treat you. We can use your information and share it with other professionals who are treating you, with your written consent where Part 2 requires it.
• To run our program. We can use and share your information to operate our program, improve your care, and contact you about appointments.
• To bill for your services. We can use and share your information to bill and get payment from health plans, including Medicaid, with your consent where required.

We are also allowed or required to share your information in other, limited ways that meet the conditions set by law — including public health and safety, health oversight audits, lawful court orders meeting Part 2 requirements, and reporting of suspected child abuse or neglect — sharing only what the law allows or requires.

Our responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you give us permission, you may change your mind at any time by telling us in writing.

Changes to this notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The current notice will always be posted on this page and available on paper at our program office.

Questions or complaints

Privacy contact: Lexi Walker
InnerCalm Wellness Recovery · (855) 586-7692 · lexi@innercalmwellness.co
89-31 161st St, Suite 402, Jamaica, NY 11432