Effective Date: January 15, 2026
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.
Mind and Thought (the “Practice”) is committed to protecting your privacy. The Practice is required by federal law to maintain the privacy of Protected Health Information (“PHI”), which is information that identifies or could be used to identify you. The Practice is required to provide you with this Notice of Privacy Practices (this “Notice”), which explains the Practice’s legal duties and privacy practices and your rights regarding PHI that we collect and maintain.
YOUR RIGHTS
Your rights regarding PHI are explained below. To exercise these rights, please submit a written request to the Practice at the address noted below.
- To inspect and copy PHI
You can ask for an electronic or paper copy of PHI. The Practice may charge you a reasonable fee. The Practice may deny your request if it believes the disclosure will endanger your life or another person’s life. You may have a right to have this decision reviewed. - To amend PHI
You can ask to correct PHI you believe is incorrect or incomplete. The Practice may require your request in writing and a reason for the request.
The Practice may deny your request and will provide a written explanation and allow you to submit a statement of disagreement. - To request confidential communications
You can ask the Practice to contact you in a specific way. The Practice will say “yes” to all reasonable requests. - To limit what is used or shared
You can ask the Practice not to use or share PHI for treatment, payment, or business operations. The Practice is not required to agree if it would affect your care. If you pay for a service or health care item out-of-pocket in full, you can ask the Practice not to share PHI with your health insurer. - You can ask the Practice not to share PHI with family members or friends by stating the specific restriction requested and to whom it applies.
- To obtain a list of disclosures
You can ask for an accounting of disclosures of your PHI. One accounting every 12 months is provided at no charge; additional requests may incur a reasonable fee. - To receive a copy of this Notice
You can request a paper copy of this Notice at any time, even if you agreed to receive it electronically. - To choose someone to act for you
If you have given someone medical power of attorney or if someone is your legal guardian, that person may exercise your rights on your behalf, as permitted by law. - To file a complaint if you feel your rights are violated
You may file a complaint with:
Mind and Thought
701 Antler, Ste. 110
Casper, WY 82601
(307) 466-8008
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by:
Mail: 200 Independence Avenue, S.W., Washington, D.C. 20201
Phone: 1-877-696-6775
Website: www.hhs.gov/ocr/privacy/hipaa/complaints/
The Practice will not retaliate against you for filing a complaint.
To opt out of fundraising communications
The Practice may contact you for fundraising efforts, but you may opt out of receiving such communications at any time.
OUR USES AND DISCLOSURES
1. Routine Uses and Disclosures of PHI
- The Practice is permitted under federal law to use and disclose PHI without your written authorization for treatment, payment, and health care operations.
- To treat you
- The Practice may use and share PHI with other professionals involved in your care.
- Example: Your primary care doctor asks about your mental health treatment.
- To run health care operations
- The Practice may use and share PHI to operate the business, improve care, and contact you.
- Example: Sending appointment reminders if you choose.
- To bill for services
- The Practice may use and share PHI to bill and receive payment from health plans or other entities.
- Example: Sharing PHI with your insurance plan for payment.
2. Uses and Disclosures of PHI That May Be Made Without Authorization or Opportunity to Object
- The Practice may use or disclose PHI without authorization for the following purposes:
- Public health and safety
- Public health activities
- Health oversight activities
- To prevent a serious and imminent threat to health or safety
- Reporting abuse, neglect, or domestic violence
- Required by government authorities
- To the Secretary of Health and Human Services for compliance investigations
- For audits, inspections, or investigations
- Law enforcement and legal proceedings
- As required by law
- In response to court orders, subpoenas, or administrative proceedings
- For law enforcement purposes
- Specialized government functions
- Military and national security activities
- Protective services and security clearances
- Workers’ compensation
- To comply with workers’ compensation laws
- Other permitted disclosures
- Coroners and funeral directors
- Organ donation
- Approved research
- Inmates
- Business associates performing services on our behalf
SPECIAL RULES FOR MINORS’ HEALTH INFORMATION
In most cases, a parent or legal guardian is considered the minor patient’s personal representative and may access the minor’s PHI. However, under certain circumstances permitted or required by federal or Wyoming state law, a minor may have the right to consent to care and control access to related PHI. In such cases, the Practice may limit or deny parental or guardian access.
These circumstances may include:
- When a minor consents to mental or behavioral health services and the law allows the minor to control the related PHI
- When services are provided without parental consent as permitted by law
- When disclosure could reasonably endanger the minor or another person
- When disclosure is prohibited by court order or law
- The Practice complies with all applicable laws governing minors’ consent and confidentiality.
MENTAL AND BEHAVIORAL HEALTH INFORMATION
- Certain mental and behavioral health information receives additional protection under federal and state law. Psychotherapy notes are kept separate from the medical record and will not be used or disclosed without written authorization, except as permitted by law.
- Mental and behavioral health information will only be disclosed for treatment, payment, or health care operations unless otherwise permitted or authorized.
- Certain substance use disorder records are protected under 42 C.F.R. Part 2 and generally require specific written authorization for disclosure.
Disclosures to Parents or Guardians
- When providing mental or behavioral health services to minors, disclosures to parents or guardians will be limited to what is permitted by law and based on clinical judgment, therapeutic need, and safety considerations.
- Safety and Legal Requirements
- The Practice may disclose mental or behavioral health information without authorization to:
- Prevent or reduce a serious and imminent threat
- Comply with mandatory reporting laws
- Respond to lawful court orders or subpoenas
3. Uses and Disclosures With Opportunity to Object
Unless you object, the Practice may disclose PHI:
- To family members, friends, or others involved in your care
- When it is in your best interest and you are unable to state your preference
4. Uses and Disclosures Requiring Written Authorization
The Practice must obtain written authorization for:
- Marketing
- Sale of PHI
- Psychotherapy notes
- You may revoke authorization at any time in writing.
OUR RESPONSIBILITIES
- Maintain the privacy and security of PHI
- Abide by the terms of this Notice
- Follow the more stringent law when state or federal laws differ
- Notify you in the event of a breach
Reserve the right to amend this Notice and make changes effective for all PHI
Updated Notices may be obtained from the Practice or viewed on our website: mindandthought.com