Notice of Privacy Practices
Desert Soul Wellness LLC
Carly Shadid, LMFT 1004
Effective Date: 10/12/26
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.
1. My Duties
Your health information is private. I am required by law to protect it. I must:
Keep your health information private.
Give you this notice of my legal duties and privacy practices.
Follow the terms of this notice.
Tell you if a breach puts your unsecured health information at risk.
“Protected Health Information” (PHI) means information about your mental health care, diagnosis, or treatment that identifies you. That includes information kept or shared electronically.
I may change this notice. A new notice applies to all the information I hold. I will post the new version on my website and give you a copy on request. [Add: and at your next session.]
2. How I May Use and Share Your PHI Without Your Permission
Treatment. I use and share PHI to provide, coordinate, and manage your care. That includes talking with other professionals involved in your care.
Payment. I use and share PHI to bill and get paid. That includes sharing information with your insurance company or other payers.
Health care operations. I use and share PHI to run my practice. That includes quality review, training, and administrative work. I may also share PHI with supervisors or consultants who help me. They are bound to keep it private.
Required by law. I share PHI when federal, state, or local law requires it.
Abuse and neglect. Nevada law requires me to report suspected abuse or neglect of a child, an older adult, or a vulnerable person. I make those reports.
Serious threats. If you communicate an imminent threat of serious harm to yourself or others, I may share information needed to prevent it. That can include contacting the person at risk or law enforcement.
Health oversight. I may share PHI with agencies that oversee health care. This includes licensing boards and audits by insurance companies.
Legal proceedings. I may share PHI in response to a court order. I may respond to a subpoena only as the law allows. If I receive a Subpoena or court order signed by a judge, it is my legal obligation to comply with the law.
Law enforcement and other legal uses. I may share limited PHI for law enforcement purposes, to comply with workers’ compensation laws, and for other uses the law allows or requires.
Public health. I may share PHI for public health activities when the law allows.
Appointment reminders. I may use your contact information to remind you of appointments.
In “Legal proceedings”: If I have your substance use disorder records protected by 42 CFR Part 2, I will not share them for investigations or legal proceedings against you unless you give written consent, or a court issues an order and a subpoena.
3. Uses That Need Your Written Permission
I must have your written permission before I:
Use or share my psychotherapy notes. These are my private notes about our sessions. I keep them separate from your record. Some limited exceptions apply, such as my own treatment use or when the law requires it.
Use your PHI for marketing.
Sell your PHI.
For any other use not described here, I will ask for your written permission. You can take it back at any time. Do it in writing. It will not undo anything I already did with your permission.
4. Your Rights
See and copy your records. You can ask to inspect or get a copy of your PHI. That includes an electronic copy. I may charge a reasonable fee. In limited cases, I can deny access. I will tell you why. Psychotherapy notes have special protection.
Ask for a correction. If you think something in your record is wrong or incomplete, you can ask me to amend it. I may say no if I believe it is correct and complete. If I do, I will explain why.
Get a list of disclosures. You can ask for a list of times I shared your PHI for reasons other than treatment, payment, and operations.
Ask for restrictions. You can ask me to limit how I use or share your PHI. I do not have to agree to every request. There is one exception. If you pay for a service fully out of pocket, you can ask me not to share information about it with your health plan. I will agree, unless the law requires me to share it.
Ask for private communication. You can ask me to contact you a certain way or at a certain place. For example, you can ask me to use a different phone number. I will honor reasonable requests.
Get a paper copy of this notice. You can ask for one at any time, even if you agreed to get it electronically.
Choose someone to act for you. If someone has legal authority to act on your behalf, I will confirm they have it before I share your PHI with them.
Be told about a breach. If your unsecured PHI is breached, I will notify you.
To use any of these rights, contact me using the details in section 7.
5. Telehealth and Electronic Records
I use Simple Practice Electronic Health Record for telehealth. I have a signed business associate agreement with them. No online system is 100% secure. I take reasonable steps to protect your privacy. I store your records in a secure, encrypted system.
6. Complaints
If you think I violated your privacy rights, you can complain to me or to the federal government. I will not retaliate against you for filing a complaint.
To file with me, use the contact details in section 7.
To file with the U.S. Department of Health and Human Services:
Office for Civil Rights
200 Independence Avenue SW
Washington, D.C. 20201
1-877-696-6775
https://www.hhs.gov/hipaa/filing-a-complaint/index.html
7. Contact
For questions about this notice or to use your rights:
Carly Shadid, LMFT
Desert Soul Wellness LLC
1070 W Horizon Ridge Pkwy #100, Henderson, NV 89012
702-850-1991
Carly@desertsoulwellness.com