Legal
This notice describes how health information may be used and disclosed and how you can get access to this information. Please review it carefully.
Vita Nova Mother-Daughter Coaching, LLC is committed to protecting the privacy of your confidential information. This notice explains how information may be used and disclosed, and outlines your rights regarding that information.
I understand that information about you and your care is personal. I am committed to protecting confidential information about you. I create a record of the care and services you receive from me, and I need this record to provide quality care and comply with legal requirements.
This notice applies to all records of your care generated by this practice. It describes the ways in which I may use and disclose health information about you, explains your rights regarding that information, and outlines certain obligations I have with respect to its use and disclosure.
The categories below describe different ways confidential information may be used and disclosed. Not every example is listed, but all permitted uses and disclosures will fall within one of these categories.
Disclosures for coaching purposes are not limited to the minimum necessary standard.
Lawsuits and Disputes: If you are involved in a lawsuit, private information may be disclosed in response to a court or administrative order. Coaching information about your child may also be disclosed in response to a subpoena, discovery request, or other lawful process, but only if efforts have been made to notify you or obtain an order protecting the requested information.
Subject to certain limitations in the law, confidential information may be used and disclosed without your Authorization for the following reasons:
Confidential information may be shared with a family member, friend, or other person you indicate is involved in your care or the payment for your care, unless you object in whole or in part. In emergency situations, the opportunity to consent may be obtained retroactively.
You may ask that certain confidential information not be used or disclosed for coaching, payment, or operations purposes. I am not required to agree if I believe it would affect your overall health.
You have the right to request restrictions on disclosures of your private information if your coaching is being paid for by a third party.
You may request that communications be sent in a specific way or to a different address, and all reasonable requests will be honored.
Other than session notes, you may request an electronic or paper copy of your entire record or part of it. A copy or agreed summary will be provided within 30 days of receiving your written request. There is a flat fee of $75 to obtain a copy of your records, regardless of the number of pages.
You may request a list of disclosures made for purposes other than treatment, payment, health care operations, or those authorized by you. A response will be provided within 60 days. The list will generally cover the previous six years unless you request a shorter period. The first list each year is free; additional requests in the same year are subject to a flat fee of $75.
If you believe your confidential information contains a mistake or is missing important information, you may request a correction or addition. If the request is denied, a written explanation will be provided within 60 days.
You have the right to receive a paper copy of this Notice and also the right to receive it by email. Even if you agree to receive it electronically, you may still request a paper copy.
If you have any questions about this Notice of Privacy Practices for Vita Nova Mother-Daughter Coaching, please contact:
Vita Nova Mother-Daughter Coaching, LLC
Erica Thomas, Certified Mother-Daughter Coach Trained By MDCI
512.777.0899
[email protected]