Serenity Wellness Centre
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Privacy Practices

Serenity Wellness Centre, LLC

Notice of Privacy Practices
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.

OVERVIEW
Serenity Wellness Centre is a site made up of independent wellness providers. As a practitioner within Serenity Wellness Centre, they agree to abide by the privacy practices described below. We follow Federal and State law regarding the use and disclosure of information about your treatment. We are required to follow the rules of this Notice. We may revise this Notice in the future to reflect changes in the law or our understanding of it. The revised Notice will apply to all information we have or will have about your treatment. You will be notified of any revision and an updated copy will be available upon request. Our commitment is to maintain your privacy and confidentiality within the limits required by your treatment, payment for your treatment, operation of your therapist's practice, your safety, the safety of others, and the law.

DEFINITIONS
The Protected Health Information (PHI): Information about your treatment or planned treatment that is identifiable as yours. This information may be in written, electronic, or verbal form. Examples include your presence in treatment, visits, financial information, assessment and testing, diagnosis, treatment plan, discharge summary, and psychotherapy notes. Psychotherapy notes include what you talk about in individual, group, couple, or family therapy sessions. They have stronger privacy protection than other PHI, as discussed in this Notice.

Consent
Your signed agreement to be treated and to the conditions of being treated by your therapist. If you do not give your consent, you cannot be treated. Consent includes limited use and disclosure of your PHI for three purposes: treatment, payment for services, and operation of your therapist's practice.

Authorization
Your signed agreement to disclose specified PHI to a specified person or organization, for specified purposes and for a specified time period. You can revoke an authorization at any time (in writing), and no further disclosures will be made.If you are under 14, your parent(s) or legal guardian(s) must sign any authorization for you and have the right to know about your treatment.

WRITTEN AUTHORIZATION
Your written authorization is required whenever your therapist wishes to disclose your
PHI to another person or organization for the purpose of treatment. Psychotherapy notes are only released with your specific authorization for the purpose of treatment. Exceptions are discussed below. Practitioners within the centre do not cross share your information without your written consent and would only do so for collaboration of your treatment.

OTHER DISCLOSURES OF YOUR PHI REQUIRED
Some disclosures of PHI are required by law with or without your consent or authorization. Information is listed below, and your therapist will discuss any such disclosure with you.

Serious Threat to Health or Safety
If your therapist has reason to believe that you are a danger to yourself or others, your therapist may release relevant information as necessary to prevent the threatened danger and/or to help you access a higher level of care, such as hospitalization. If you disclose to your therapist a homicidal plan of violence against an identifiable victim(s), your therapist must make reasonable efforts to communicate that information to the potential victim and the police.

Child Abuse
Whenever your therapist reasonably suspects that a child with whom he or she has direct contact has been the victim of abuse or neglect, your therapist must immediately make a report to a State-wide hotline. The information is then forwarded to the local Child and Youth Services. If there appears to be imminent danger your therapist will also contact the police.

Adult Abuse
If your therapist reasonably suspects an elder or dependent adult he or she has direct contact with has been the victim of abuse or neglect, your therapist must report the suspected abuse or neglect immediately to the elder abuse hotline or the local Area Agency on Aging.



Serenity Wellness Centre
International Virtual Wellness Centre
Phone 1-814-422-6190
[email protected]
​Mailing Address availbale upon request
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© Serenity Wellness Center, LLC 2016 All Rights Reserved. 
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