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Peace by Piece Concierge Therapy, LLC
Effective Date: July 27, 2026

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

At Peace by Piece Concierge Therapy, LLC, we understand that your health information is personal. We are committed to protecting the privacy and confidentiality of your Protected Health Information (PHI) in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and other applicable laws.


Our Commitment to Your Privacy

We are required by law to:

Protected Health Information includes information about your mental health, treatment, diagnosis, payment for services, and any information that identifies you.


How We May Use and Disclose Your Information

1. For Treatment

We may use or share your health information to provide, coordinate, or manage your treatment.

Examples include:


2. For Payment

We may use your information to:

Insurance companies may receive information necessary to process your claims.


3. For Health Care Operations

We may use your information to:


4. Appointment Reminders

We may contact you regarding:

Unless you instruct us otherwise, reminders may be sent by:


5. Individuals Involved in Your Care

With your permission, or when permitted by law, we may share relevant information with:

You may tell us at any time not to share information with these individuals.


Uses That Require Your Written Authorization

Except as otherwise permitted or required by law, we will obtain your written authorization before:

You may revoke your authorization at any time in writing, except to the extent we have already relied on it.


Situations Where We May Disclose Information Without Authorization

HIPAA permits or requires disclosures in certain situations, including:


Your Rights Regarding Your Health Information

You Have the Right To:

Inspect and Obtain a Copy

You may request access to your health records and obtain copies as permitted by law.


Request an Amendment

If you believe information in your record is incorrect or incomplete, you may request an amendment.

We may deny certain requests but will explain the reason in writing.


Request Restrictions

You may request restrictions on how your information is used or disclosed.

Although we will consider every request, we are not required to agree to every restriction except where required by law.


Request Confidential Communications

You may request that we contact you:

We will accommodate reasonable requests.


Receive an Accounting of Disclosures

You may request a list of certain disclosures we have made of your Protected Health Information, excluding disclosures made for treatment, payment, healthcare operations, and certain other exceptions permitted by HIPAA.


Receive a Paper Copy of This Notice

You have the right to receive a paper copy of this Notice at any time, even if you agreed to receive it electronically.


File a Complaint

You may file a complaint if you believe your privacy rights have been violated.

You may contact:

Peace by Piece Concierge Therapy, LLC

Phone: (302) 505-0466

Email: [Insert Practice Email]

You may also file a complaint with:

U.S. Department of Health and Human Services
Office for Civil Rights

You will not be penalized or retaliated against for filing a complaint.


Our Responsibilities

We are required to:


Electronic Communications

Peace by Piece Concierge Therapy uses electronic systems to support scheduling, billing, documentation, and client communication.

While we employ reasonable safeguards to protect your information, electronic communication carries inherent risks. We encourage clients to use our secure client portal for confidential communications whenever possible.


Telehealth Services

When participating in telehealth services, we use secure technology designed to protect your privacy.

Clients are encouraged to participate in telehealth sessions from a private location and to take reasonable steps to protect their own confidentiality during sessions.


Website and Online Store

This Notice applies to your Protected Health Information received as part of therapy services.

Information collected through our public website or online store is governed by our separate Website Privacy Policy.

Please do not submit confidential clinical information through website contact forms, online shopping pages, or email unless specifically instructed.


Changes to This Notice

We reserve the right to change this Notice at any time.

Updated versions will be posted on our website and will apply to all Protected Health Information maintained by Peace by Piece Concierge Therapy unless otherwise required by law.


Contact Information

Peace by Piece Concierge Therapy, LLC

📞 Phone: (302) 505-0466

📧 Email: admin@peacebypiececoncierge.com

🌐 Website: https://peacebypiececoncierge.com


Acknowledgment

Clients are encouraged to review this Notice carefully. A copy will be made available upon request and during the client onboarding process.


Effective Date: July 27, 2026