NOTICE OF PRIVACY PRACTICES

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.

The Reality of Hope CES (the "Practice") is committed to protecting your privacy. The Practice is required by federal law
to maintain the privacy of Protected Health Information ("PHI"), which is information that identifies or could be used to
identify you. The Practice is required to provide you with this Notice of Privacy Practices (this "Notice"), which explains
the Practice's legal duties and privacy practices and your rights regarding PHI that we collect and maintain.

YOUR RIGHTS

Your rights regarding PHI are explained below. To exercise these rights, please submit a written request to the Practice
at the address noted below.

To inspect and copy PHI.
You can ask for an electronic or paper copy of PHI. The Practice may charge you a reasonable fee.
The Practice may deny your request if it believes the disclosure will endanger your life or another person's life.
You may have a right to have this decision reviewed.

To amend PHI.
You can ask to correct PHI you believe is incorrect or incomplete. The Practice may require you to make your
request in writing and provide a reason for the request.
The Practice may deny your request. The Practice will send a written explanation for the denial and allow you
to submit a written statement of disagreement.

To request confidential communications.
You can ask the Practice to contact you in a specific way. The Practice will say "yes" to all reasonable
requests.

To limit what is used or shared.
You can ask the Practice not to use or share PHI for treatment, payment, or business operations. The Practice
is not required to agree if it would affect your care.
If you pay for a service or health care item out-of-pocket in full, you can ask the Practice not to share PHI with
your health insurer.
You can ask for the Practice not to share your PHI with family members or friends by stating the specific
restriction requested and to whom you want the restriction to apply.

To obtain a list of those with whom your PHI has been shared.
You can ask for a list, called an accounting, of the times your health information has been shared. You can
receive one accounting every 12 months at no charge, but you may be charged a reasonable fee if you ask for
one more frequently.

To receive a copy of this Notice.
You can ask for a paper copy of this Notice, even if you agreed to receive the Notice electronically.

To choose someone to act for you.
If you have given someone medical power of attorney or if someone is your legal guardian, that person can
exercise your rights.

To file a complaint if you feel your rights are violated.
You can file a complaint by contacting the Practice using the following information: Reality of Hope CES 2295
West Market St. Suite J Akron, Ohio 44313 Dr. Yvette Lester 330 614-5438
You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by
sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting
www.hhs.gov/ocr/privacy/hipaa/complaints/.
The Practice will not retaliate against you for filing a complaint.

To opt out of receiving fundraising communications.
The Practice may contact you for fundraising efforts, but you can ask not to be contacted again.

OUR USES AND DISCLOSURES

1. Routine uses and Disclosures of PHI

The Practice is permitted under federal law to use and disclose PHI, without your written authorization, for certain
routine uses and disclosures, such as those made for treatment, payment, and the operation of our business. The
Practice typically uses or shares your health information in the following ways:

To treat you.
The Practice can use and share PHI with other professionals who are treating you.
Example: Your primary care doctor asks about your mental health treatment.

To run the health care operations.
The Practice can use and share PHI to run the business, improve your care, and contact you.
Example: The Practice uses PHI to send you appointment reminders if you choose.

To bill your service.
The Practice can use and share PHI to bill and get payment from health plans or other entities.
Example: The Practice gives PHI to your health insurance plan so it will pay for your services.

2. Uses and Disclosures of PHI That May Be Made Without Your Authorization or Opportunity to Object.
The Practice may use or disclose PHI without your authorization or an opportunity for you to object, including:

To help with public health and safety issues
Public health: To prevent the spread of disease, assist in product recalls, and report adverse reactions to
medication.
Required by the Secretary of Health and Human Services: We may be required to disclose your PHI to the Secretary
of Health and Human Services to investigate or determine our compliance with the requirements of the final rule on
Standards for Privacy of Individually Identifiable Health Information.
Health oversight: For audits, investigations, and inspections by government agencies that oversee the health care
system, government benefit programs, other government regulatory programs, and civil rights laws.
Serious threat to health or safety: To prevent a serious and imminent threat.
Abuse or Neglect: To report abuse, neglect, or domestic violence.

To comply with law, law enforcement, or other government requests
Required by law: If required by federal, state or local law.
Judicial and administrative proceedings: To respond to a court order, subpoena, or discovery request.
Law enforcement: For law locate and identify you or disclose information about a victim of a crime.
Specialized Government Functions: For military or national security concerns, including intelligence, protective
services for heads of state, or your security clearance.
National security and intelligence activities: For intelligence, counterintelligence, protection of the President, other
authorized persons or foreign heads of state, for purpose of determining your own security clearance and other
national security activities authorized by law.
Workers' Compensation: To comply with workers' compensation laws or support claims.

To comply with other requests
Coroners and Funeral Directors: To perform their legally authorized duties.
Organ Donation: For organ donation or transplantation.
Research: For research that has been approved by an institutional review board.
Inmates: The Practice created or received your PHI in the course of providing care.
Business Associates: To organizations that perform functions, activities or services on our behalf.

3. Uses and Disclosures of PHI That May Be Made With Your Authorization or Opportunity to Object
Unless you object, the Practice may disclose PHI:
To your family, friends, or others if PHI directly relates to that person's involvement in your care.
If it is in your best interest because you are unable to state your preference.

4. Uses and Disclosures of PHI Based Upon Your Written Authorization
The Practice must obtain your written authorization to use and/or disclose PHI for the following purposes:
Marketing, sale of PHI, and psychotherapy notes.
You may revoke your authorization, at any time, by contacting the Practice in writing, using the information above. The
Practice will not use or share PHI other than as described in Notice unless you give your permission in writing.

OUR RESPONSIBILITIES

The Practice is required by law to maintain the privacy and security of PHI.
The Practice is required to abide by the terms of this Notice currently in effect. Where more stringent state or
federal law governs PHI, the Practice will abide by the more stringent law.
The Practice reserves the right to amend Notice. All changes are applicable to PHI collected and maintained by the
Practice. Should the Practice make changes, you may obtain a revised Notice by requesting a copy from the
Practice, using the information above, or by viewing a copy on the website www.realityofhope.com
The Practice will inform you if PHI is compromised in a breach.

This Notice is effective on 01/01/2025.