Foundational Roots Therapy Notice of Privacy Practices (HIPAA)
Effective Date: February 26, 2026
This Notice of Privacy Practices 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.
1. Our Legal Duty
2. How We May Use and Disclose Your Information
Treatment: We may use and disclose your PHI to provide, coordinate, or manage your mental health treatment.
Payment: We may use and disclose PHI to obtain payment for services, including insurance billing.
Health Care Operations: We may use PHI for administrative, quality assurance, and business operations.
Required by Law: We may disclose PHI when required by federal or Washington State law, including mandatory reporting of child abuse (RCW 26.44), vulnerable adult abuse, or court orders.
Serious Threat to Health or Safety: We may disclose PHI if necessary to prevent or lessen a serious and imminent threat to your health or safety or that of another person.
Public Health Activities: We may disclose PHI for public health reporting as required by law.
3. Uses and Disclosures Requiring Authorization
Other uses and disclosures of PHI not covered by this Notice will be made only with your written authorization. You may revoke your authorization at any time in writing, except to the extent action has already been taken.
4. Your Rights Regarding Your PHI
You have the right to:
- Request restrictions on certain uses and disclosures.
- Receive confidential communications by alternative means or locations.
- Inspect and obtain a copy of your record (with limited clinical exceptions).
- Request amendments to your record.
- Receive an accounting of disclosures.
- Receive a paper copy of this Notice upon request.