Exceptional Psychiatric Services -Notice of Privacy Practices
(Effective December 2025)
Purpose
This Notice describes how medical and mental health information about you may be used and
disclosed, and how you can access this information. Please review it carefully.
Exceptional Psychiatric Services respects your privacy and is committed to protecting your personal health information (PHI). We are required by law to maintain the privacy of your records and to provide you with this notice of our legal duties and privacy practices.
How We May Use and Disclose Your Information
Your health information may be used and shared for the following purposes without
additional written consent:
● Treatment: To provide, coordinate, and manage your healthcare and related services.
● Payment: To obtain payment or reimbursement from insurance plans or third parties.
● Healthcare Operations: For quality improvement, administrative management,
compliance reviews, and staff training.
Other permitted uses include appointment reminders, care coordination, or sharing limited
information with laboratories, pharmacies, or other healthcare providers involved in your care.
Uses Requiring Your Written Authorization
Your written permission is required before we can share your information for:
● Marketing or fundraising purposes.
● Disclosure to third parties not involved in your care.
● Exceptional Psychiatric Services does not maintain separate psychotherapy notes. Progress
notes are part of your standard medical record and may be used for treatment, payment,
and healthcare operations as permitted by law.
● You may revoke authorization in writing at any time.
Your Rights Regarding Your Health Information
You have the right to:
● Access and obtain copies of your medical record.
● Request corrections to information you believe is inaccurate or incomplete.
● Request restrictions on certain uses or disclosures (though we may not always be able to
agree).
● Request confidential communications through specific contact methods.
● Receive an accounting of disclosures made without your authorization.
● Receive a copy of this notice electronically or in paper form at any time.
Requests must be made in writing to the Privacy Officer listed below.
Confidentiality and Limits
Information may be disclosed without your authorization only when required or permitted
by law, such as:
● Suspected abuse or neglect of a child, elderly, or dependent adult.
● Danger to yourself or others.
● Public health and safety reporting.
● Court orders or subpoenas.
● Law enforcement or national security requests as required by law.
Electronic Systems and Communication
Exceptional Psychiatric Services • nicole@epshealth.org • Phone: 225-442-9209 • Fax: 640 230 7320
Confidentiality Notice: This communication may contain PHI. If you received this in error, please contact sender and delete.
Exceptional Psychiatric Services uses HIPAA-compliant technology for recordkeeping, telehealth, and billing, including SimplePractice, Doximity, and Hushmail.
Email or text communication is used only for administrative purposes such as scheduling,
reminders, or billing. Clinical information should never be sent through unsecured channels.
Our Responsibilities
Exceptional Psychiatric Services is required by law to:
● Maintain the privacy and security of your health information.
● Notify you if a breach of unsecured PHI occurs.
● Abide by the terms of this notice.
● Provide updates to this notice when changes are made.
We reserve the right to amend this policy at any time. Updated versions will be posted in our
office and on our website.
Questions or Complaints
If you have questions, wish to exercise your rights, or believe your privacy rights have been
violated, contact:
Privacy Officer:
Shandar Bennett, Office Manager
Exceptional Psychiatric Services
[Email: nicole@epshealth.org]
[Phone: 225-442-9209]
You may also file a complaint with the U.S. Department of Health and Human Services,
Office for Civil Rights at:
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Website: www.hhs.gov/ocr/privacy
You will not face retaliation for filing a complaint.