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NOTICE OF PRIVACY PRACTICES (NPP)

Effective Date: August 11, 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.

Practice Entity: Blue Heron, LLC dba Utah Men’s Therapy

Designated Privacy Officer: Taylor Chambers, MS, LMFT

Contact Email: [email protected]

Contact Phone: (435)574-9120

1. OUR LEGAL DUTY TO PROTECT YOUR HEALTH INFORMATION

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Blue Heron, LLC dba Utah Men’s Therapy is required by law to maintain the privacy and security of your Protected Health Information (PHI). PHI includes individually identifiable information regarding your physical or mental health, treatment history, or payment for healthcare services.

We are required to:

  • Provide you with this Notice detailing our legal duties and privacy practices.
  • Follow the privacy terms described in this Notice while it is in effect.
  • Notify you promptly in the event of a breach of your unsecured PHI.


2. PERMITTED USES & DISCLOSURES FOR TREATMENT, PAYMENT & OPERATIONS

We may use and disclose your PHI without your explicit written authorization for the following primary healthcare purposes:

  • Treatment: We use your PHI to provide, manage, and coordinate your psychotherapy care. For example, your therapist may use clinical documentation to plan your treatment goals or consult with a clinical supervisor or peer consultation team under strict confidentiality.
  • Payment: We may use and disclose PHI to bill and collect payment for services rendered. For example, if you utilize third-party billing, or credit card processors (e.g., SimplePractice), necessary information (such as diagnosis codes, dates of service, and fees) may be shared to process payments.
  • Healthcare Operations: We may use PHI for internal business management and operations necessary to run our practice, such as quality assessment, technology security audits, legal compliance, and financial management.


3. DISCLOSURES REQUIRING YOUR EXPLICIT WRITTEN AUTHORIZATION

Any other uses or disclosures not covered by this Notice will be made only with your explicit written authorization via a standalone Authorization for Release of Information (ROI). You may revoke such authorization in writing at any time.

Specific examples requiring explicit authorization include:

  • Marketing & Sale of Information: We will never sell your PHI or use your clinical data for marketing or commercial advertising.
  • Psychotherapy Notes: Process notes kept separate from your medical record require a specific, separate authorization for disclosure.
  • Third-Party Disclosures: Sharing records with family members, external physicians, attorneys, or former treatment providers.


4. SPECIAL PROVISIONS: ARTIFICIAL INTELLIGENCE & VENDOR PROTECTIONS

  • Business Associates: We partner with trusted third-party technology vendors (e.g., SimplePractice for EHR, encrypted video platforms, and HIPAA-compliant AI documentation scribe tools) to perform administrative functions. Every vendor that touches PHI must sign a legally binding Business Associate Agreement (BAA) committing them to bank-level encryption and strict HIPAA security standards.
  • AI Clinical Tools: AI technology used by this practice operates under strict HIPAA BAAs. Session data processed by AI scribe tools is used strictly for generating clinical documentation and assistance, is encrypted in transit and at rest, and is never retained to train public machine-learning models.


5. LEGALLY MANDATED DISCLOSURES WITHOUT YOUR CONSENT

Federal and state laws permit or require us to disclose your PHI without your authorization or opportunity to object under specific circumstances:

  1. Child Abuse or Neglect: If we have reason to suspect that a child has been subjected to physical abuse, sexual abuse, or neglect, we are mandatory reporters required by law to report to relevant state authorities (e.g., Utah Division of Child and Family Services).
  2. Vulnerable Adult/Elder Abuse: Suspected abuse, neglect, or exploitation of an elderly or vulnerable adult must be reported to protective services.
  3. Imminent Harm to Self or Others: If you present an imminent, clear danger of serious physical harm or death to yourself or another person, we are legally permitted (and ethically obligated) to take protective action, which may include notifying law enforcement, contacting emergency personnel, or alerting an intended victim.
  4. Court Orders & Legal Proceedings: We may disclose PHI if mandated by a judge's formal court order, judicial subpoena, or administrative tribunal order.
  5. Health Oversight & Law Enforcement: Disclosures required for state licensing board investigations (e.g., Utah DOPL) or federal compliance audits conducted by the U.S. Department of Health and Human Services (HHS).


6. YOUR INDIVIDUAL RIGHTS REGARDING YOUR HEALTH INFORMATION

Under federal law, you have the following rights regarding the PHI we maintain about you:

  • Right to Inspect and Copy: You have the right to inspect and obtain an electronic or paper copy of your clinical record. Requests must be submitted in writing.
  • Right to Request Restrictions: You may ask us not to use or share certain PHI for treatment, payment, or operations. While we will consider all requests, we are not legally required to agree if it impacts your safety or legal obligations.
  • Right to Request Confidential Communications: You may request that we communicate with you in a specific way (e.g., portal messaging only, no voicemail to home numbers) or send documents to an alternate address.
  • Right to Amend Records: If you feel clinical information in your record is incorrect or incomplete, you may request an amendment in writing. We may deny your request under certain conditions, but we will provide a written explanation within 60 days.
  • Right to an Accounting of Disclosures: You may request a list (an "accounting") of the instances in which we have shared your PHI for purposes other than treatment, payment, or routine operations during the past six years.
  • Right to a Paper Copy: You have the right to request a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.


7. REVISIONS TO THIS NOTICE

We reserve the right to change the terms of this Notice at any time. Revised notices will apply to all PHI we maintain. Updated notices will be posted on our website utahmenshealth.com and made available upon request.


8. QUESTIONS & COMPLAINTS

If you believe your privacy rights have been violated, or if you have questions about this Notice, please contact our Privacy Officer:

Designated Privacy Officer: Taylor Chambers, LMFT / Blue Heron, LLC dba Utah Men’s Therapy

Email: [email protected]

Phone: (435) 574-9120

You may also file a formal complaint with the federal government by writing to the U.S. Department of Health and Human Services Office for Civil Rights (OCR):

  • Web Portal: https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf
  • Mail: Centralized Case Management Operations, U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Room 509F, HHH Building, Washington, D.C. 20201
  • Phone: 1-800-368-1019 (TDD: 1-800-537-7697)

We will not retaliate or penalize you in any way for filing a privacy complaint.