NOTICE OF PRIVACY PRACTICES

Grace Therapy and Wellness Center (GTWC) Effective Date: June 2021 | Updated: July 2026

This Notice describes how your medical, mental health, and communication information—including SMS/text message data—may be used and disclosed, and how you may access this information. Please review it carefully. A copy of this Notice is available on our website or upon request.

SUMMARY OF PRIVACY PRACTICES

Your Rights

You have the right to:

• Access your paper or electronic medical record.

• Request corrections to your medical record.

• Request confidential communication methods.

• Ask us to limit what information we use or share.

• Obtain a list of those with whom we have shared your information.

• Receive a paper copy of this Notice at any time.

• Choose someone to act on your behalf.

• File a complaint if you believe your privacy rights have been violated.

Your Choices

You may tell us your preferences regarding:

• Sharing information with family, friends, or others involved in your care.

• Sharing information during disaster relief efforts.

• How we use your information for marketing or fundraising.

• Whether we may sell your information (we do not).

Our Uses and Disclosures

We may use and disclose your information to:

• Treat you.

• Bill you or a third party for services.

• Conduct healthcare operations, including quality improvement and audits.

• Comply with federal, state, or local laws.

• Assist with public health and safety issues.

• Respond to legal actions, law enforcement requests, or government functions.

• Conduct research when permitted by law.

DETAILED PATIENT RIGHTS

Right to Access

You may request to see or obtain an electronic or paper copy of your medical record and other health information we maintain. We will provide a copy or summary within 30 days. A reasonable, cost‑based fee may apply.

You do not have the right to access information unrelated to your care, such as business planning records, quality assessments, or internal administrative documents.

Right to Request Corrections

If you believe your medical record is incorrect or incomplete, you may request an amendment. If we deny your request, we will provide a written explanation within 60 days.

Right to Request Confidential Communications

You may request that we contact you in a specific way (e.g., only at a certain phone number or address). We will accommodate all reasonable requests.

Right to Request Restrictions

You may ask us not to use or share certain health information for treatment, payment, or operations. We are not required to agree unless you have paid for a service out‑of‑pocket in full and request that we not share that information with your insurer.

If we agree to a restriction, we must follow it except in emergencies.

Right to an Accounting of Disclosures

You may request a list of disclosures of your health information for the six years prior to your request. This excludes disclosures for treatment, payment, operations, and certain other routine uses. One accounting per year is free; additional requests may incur a reasonable fee.

Right to a Paper Copy of This Notice

You may request a paper copy of this Notice at any time.

Right to Choose a Representative

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. We will verify their authority before taking action.

Right to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with:

U.S. Department of Health and Human Services Office for Civil Rights 200 Independence Avenue, S.W. Washington, D.C. 20201 Phone: (877) 696‑6675 Website: www.hhs.gov

You may also contact GTWC’s Privacy Officer. We will not retaliate against you for filing a complaint.

DETAILED PATIENT CHOICES

In certain situations, you may tell us your preferences about how we share your information. You may instruct us on whether to:

• Share information with family members or others involved in your care.

• Share information during disaster relief efforts.

If you are unable to express your preferences (e.g., due to incapacity), we may share information if we believe it is in your best interest or necessary to prevent a serious and imminent threat to health or safety.

We will never share your information without written permission for:

• Marketing purposes.

• Sale of your information.

• Sharing psychotherapy notes or HIV‑related information, unless required by law.

DETAILED USES AND DISCLOSURES

Treatment

We may use and share your information with other professionals involved in your care, including providers outside GTWC when necessary.

Payment

We may use and share your information to bill and receive payment from health plans or other payers.

Healthcare Operations

We may use and share your information to operate our practice, improve services, conduct audits, and ensure quality of care.

Public Health and Safety

We may disclose information to:

• Report suspected abuse, neglect, or domestic violence.

• Prevent or reduce a serious threat to health or safety.

• Assist with disease prevention, product recalls, or adverse event reporting.

Research

We may use or share your information for research when permitted by law.

Legal and Government Requests

We may disclose information to:

• Comply with federal or state laws.

• Respond to court orders, subpoenas, or administrative requests.

• Assist law enforcement.

• Support government functions such as national security or military activities.

• Respond to workers’ compensation claims.

Compliance

We may share information with the Department of Health and Human Services to demonstrate compliance with federal privacy laws.

SMS/TEXT MESSAGE PRIVACY PRACTICES

Grace Therapy & Wellness Center values the privacy and confidentiality of all client communication, including SMS/text messaging. This section describes how we collect, use, protect, and disclose SMS data.

Types of SMS Data Collected

When you communicate with GTWC via SMS, we may collect:

• Your phone number

• The content of your messages

• Information needed to respond to your inquiries or coordinate care

This information is used solely for communication related to your care, scheduling, or support needs. We will not use your SMS data for any other purpose without your written consent.

Protection of SMS Data

GTWC uses industry‑standard security measures to protect SMS data from unauthorized access, disclosure, alteration, or destruction.

Disclosure of SMS Data

GTWC does not disclose SMS contact or content data to third parties unless:

• Required by law

• Necessary to protect the rights, property, or safety of GTWC, its clients, or others

Your Rights Regarding SMS Data

You have the right to:

• Access, correct, or request deletion of your SMS contact or content data (unless retention is required by law)

• Request information about how your SMS data is used

To exercise your rights, contact us at: [email protected] (773) 423-8447

Retention of SMS Data

GTWC retains SMS and personal data only as long as necessary to fulfill communication or care‑related purposes, or to meet legal, accounting, or reporting requirements.

We may anonymize data for research or statistical purposes; anonymized data may be used indefinitely.

OUR RESPONSIBILITIES

We are required by law to:

• Maintain the privacy and security of your protected health information.

• Notify you promptly if a breach occurs that may compromise your information.

• Follow the duties and privacy practices described in this Notice.

• Provide you with a copy of this Notice upon request.

• Not use or share your information other than as described here unless you authorize it in writing. You may revoke an authorization at any time.

For more information, visit: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html

ABOUT THIS NOTICE

This Notice is effective June 2021. GTWC’s Chief Privacy Officer is Elana Thomas, who may be contacted at: 105 N Oak Park Ave, Oak Park, IL 60301

We may change the terms of this Notice at any time. Changes will apply to all information we maintain and will be available upon request and on our website.