This Notice describes how Active Vitality Therapy Solutions, LLC may use and disclose your Protected Health Information (PHI) and how you can access and manage your information. Please review it carefully.
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.
Last Updated: January 26, 2026
Effective Date: January 26, 2026
OVERVIEW
This HIPAA Notice of Privacy Practices (this “Notice”) describes how Active Vitality Therapy Solutions, LLC (the “Practice,” “we,” “us,” or “our”) may use and disclose medical information about you, and how you can access and manage your information.
This Notice applies only to information that is “protected health information” (“PHI”) under the Health Insurance Portability and Accountability Act (“HIPAA”). PHI generally means individually identifiable information about your health, mental health, the care you receive, or payment for care.
This Notice does not apply to information that is not covered by HIPAA (for example, general website analytics or non-clinical inquiries submitted through the website). Please see our Website Privacy Policy for how we handle non-HIPAA website information.
We are required by law to:
• Ensure that PHI that identifies you is kept private and secure;
• Provide you with this Notice describing our legal duties and privacy practices;
• Notify you following a breach of unsecured PHI, as required by law; and
• Follow the terms of the Notice that are currently in effect.
You have the right to request a paper copy of this Notice at any time, even if you have received it electronically.
We reserve the right to change the terms of this Notice at any time. Any changes will apply to all PHI we maintain. The current Notice will be available on our website and upon request.
HOW YOUR INFORMATION IS USED
We may use and disclose your PHI for purposes related to providing services and quality care. HIPAA allows (and sometimes requires) us to use and disclose PHI for the following purposes:
1) Treatment
We may use and share PHI to provide, coordinate, or manage your care.
Examples:
• Coordinating with another provider involved in your care when clinically appropriate and permitted by law
• Referring you to another provider or community resource at your request
2) Payment
We may use and disclose PHI to bill and receive payment for services.
Examples:
• Submitting claims to your health plan (if you use insurance)
• Verifying coverage/benefits and communicating with your health plan about payment
• Coordinating billing and payment processing
3) Health Care Operations
We may use and disclose PHI to operate our practice and support quality care.
Examples:
• Practice administration and quality improvement
• Auditing and compliance activities
• Reviewing documentation for quality and continuity of care
Scheduling and Appointment Reminders
We may contact you (by phone, voicemail, email, text, or portal message) to schedule appointments, send reminders, or coordinate care-related logistics. You may request preferred methods of communication.
Business Associates (Service Providers)
We use trusted service providers to help us operate our practice. When required, we use agreements to requirethese vendors to safeguard PHI and only use it as permitted by HIPAA and our contracts.
Examples of vendors and platforms that may be involved in providing services include:
• Headway (insurance and related administrative/billing support, if you choose to use insurance)
• SimplePractice (secure client portal/EHR and practice administration)
• Spruce (secure communication platform used for calling and messaging)
USES AND DISCLOSURES THAT REQUIRE YOUR WRITTEN AUTHORIZATION
For uses and disclosures not described above, we will obtain your written authorization unless an exception applies under law.
We generally need your written authorization for:
• Uses/disclosures of psychotherapy notes (as defined by HIPAA), with limited exceptions permitted by law
• Most uses/disclosures for marketing purposes
• Any sale of PHI
You can revoke (cancel) an authorization in writing at any time. Revocation stops future uses/disclosures, but cannot undo actions already taken based on your prior authorization.
DISCLOSURES THAT CAN BE MADE WITHOUT AN AUTHORIZATION
HIPAA and other laws allow or require disclosure in certain situations, including:
Emergencies / Safety
We may disclose PHI when necessary to reduce or prevent a serious and imminent threat to your health/safety
or the health/safety of others, consistent with applicable law.
Abuse, Neglect, or Domestic Violence
We may disclose PHI if we reasonably suspect abuse or neglect, or as otherwise required/permitted by law.
Legal Proceedings and Law Enforcement
We may disclose PHI in response to a valid court order, subpoena, or other lawful process as permitted by law.
Public Health and Health Oversight
We may disclose PHI for public health activities or to oversight agencies for activities authorized by law (such as audits, investigations, inspections, or licensing).
Workers’ Compensation
We may disclose PHI for workers’ compensation claims as permitted by law.
Coroners / Medical Examiners
We may disclose PHI to a coroner or medical examiner as permitted by law.
YOUR INDIVIDUAL RIGHTS
You have the following rights regarding your PHI (with limited exceptions under law). To exercise any right, contact the Practice using the “Contact” section below. We may ask you to submit requests in writing and verify your identity.
Right to Inspect and Copy
You have the right to inspect and obtain a copy of your PHI, with limited exceptions. We may charge a reasonable, cost-based fee.
Right to Amend
You have the right to request an amendment (correction) to your PHI. We may deny the request in certain circumstances, but we will provide a written explanation.
Right to an Accounting of Disclosures
You have the right to request a list of certain disclosures of your PHI made for purposes other than treatment, payment, and health care operations, and certain other disclosures excluded by HIPAA. This accounting is generally available for up to six years prior to your request.
Right to Request Restrictions
You have the right to request restrictions on how we use/disclose your PHI for treatment, payment, or operations. We are not required to agree to all requested restrictions.
If you pay for a service in full out-of-pocket and request that we not disclose PHI about that service to your health plan for payment or operations, we will comply unless required by law.
Right to Request Confidential Communications
You can request that we communicate with you in a specific way (for example, only by email, only by phone, or through secure messaging). We will accommodate reasonable requests.
Right to a Copy of This Notice
You have the right to request a paper copy of this Notice at any time.
Right to Choose Someone to Act for You
If you have a legal guardian or a person with medical power of attorney, that person may exercise your rights once we receive appropriate documentation.
Right to File a Complaint
If you believe your privacy rights have been violated, you may file a complaint with the Practice and/or with the U.S. Department of Health and Human Services, Office for Civil Rights (OCR). We will not retaliate against you for filing a complaint.
EMAIL AND TEXT MESSAGES (IMPORTANT)
Different communication channels have different privacy and security characteristics.
We offer secure messaging options (including secure messaging features within Spruce). Spruce also supports standard messaging channels (such as SMS) that may not provide the same level of privacy as secure in-app messaging.
Email and text messages may be misdirected, intercepted, or accessed by others who use your device or accounts. If you choose to communicate by email or text, you do so with these risks in mind.
At our discretion, communications related to your care may become part of your clinical record.
Do not use email or text for emergencies.
CHANGES TO THIS NOTICE
We may update this Notice from time to time. Any updated version will apply to all PHI we maintain and will be made available on our website and upon request.
CONTACT (PRIVACY OFFICER)
Active Vitality Therapy Solutions, LLC
Privacy Officer: Catherine Stallings, LCSW
Email: catherine@activevitalitytherapy.com
Phone: (540) 712-3849
If you have questions about this Notice, would like to exercise your rights, or want to file a complaint with the Practice, contact the Privacy Officer using the information above.
