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Effective date: April 2026

How we use and disclose your information

We use your protected health information for the following purposes without requiring your written authorization:

  • Treatment. To provide, coordinate, and manage your healthcare.
  • Payment. To bill your insurance and process payments.
  • Healthcare operations. To run the practice (quality assessment, training, audits) using only the minimum information necessary.

For other uses, we will obtain your written authorization. You may revoke that authorization at any time.

Your rights

  • Right to access your medical record (we provide it within 30 days)
  • Right to ask us to correct information you believe is wrong
  • Right to a list of disclosures we have made of your information
  • Right to ask us to limit how we use or disclose certain information
  • Right to ask us to contact you in a specific way (phone instead of email)
  • Right to a paper copy of this notice anytime
  • Right to file a complaint with us, the U.S. Department of Health and Human Services Office for Civil Rights, or the Connecticut Department of Public Health

Special protections for mental health information

Connecticut state law and federal regulations provide additional protections for mental health and substance use information beyond standard HIPAA. We will not release psychotherapy notes, substance use treatment records, or HIV-related information without your specific written authorization, except in narrow circumstances required by law.

Security

  • Encrypted electronic health records and communications
  • Access controls limiting who can see your information
  • Staff training on privacy and security
  • Regular risk assessments
  • Business Associate Agreements with vendors who handle health information

Contact

To exercise any of your rights, request a paper copy of this notice, or file a privacy complaint:

Northline Psychiatry, Inc.
Privacy Officer
339 Flanders Rd
East Lyme, CT 06333
privacy@northlinepsych.com
(860) 385-6547

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights at hhs.gov/ocr.