Effective Date: 10/28/2026

Stacey Bayer, LCSW, SEP

THIS NOTICE DESCRIBES HOW MEDICAL AND MENTAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Your privacy is important to me. I am required by law to protect the privacy and security of your protected health information (PHI), provide you with this Notice of Privacy Practices, and follow the privacy practices described in the notice that is currently in effect.

This notice explains how I may use and disclose your health information, your rights regarding that information, and my responsibilities for protecting your privacy.

Your Rights

You have certain rights regarding your health information.

Get a copy of your health records

You may ask to see or obtain an electronic or paper copy of your health information.

I will provide a copy or summary of your health information as required by law. In some circumstances, access to certain information may be limited as permitted by law.

A reasonable, cost-based fee may apply when permitted by law.

Ask me to correct your health information

You may ask me to correct health information that you believe is incorrect or incomplete.

I may deny your request in certain circumstances, but I will explain the reason for the denial in writing as required by law.

Request confidential communications

You may ask me to contact you in a particular way or at a particular location. For example, you may request that I contact you only at a certain phone number or email address.

I will accommodate reasonable requests as required by law.

Ask me to limit what I use or disclose

You may ask me not to use or disclose certain health information for treatment, payment, or health care operations.

I am not always required to agree to your request.

If you pay for a service in full out of pocket and ask me not to disclose information about that service to your health plan for purposes of payment or health care operations, I will honor that request unless disclosure