Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed, how you can obtain access to it, and the responsibilities of Inclusive Behavioral Health PC.
Your rights
You have rights regarding your health information. Subject to applicable law and limited exceptions, you may:
- Inspect or obtain a paper or electronic copy of your medical record.
- Ask us to correct health information that you believe is incorrect or incomplete.
- Ask us to communicate with you in a specific way or at a specific location.
- Ask us to limit certain uses or disclosures of your information. We are not required to agree to every request, but we will consider it as required by law.
- Ask us not to share information about an item or service with your health insurer for payment or health care operations when you have paid for that item or service in full out of pocket, when the law requires us to honor that request.
- Request an accounting of certain disclosures of your health information.
- Obtain a paper copy of this notice at any time.
- Choose a legally authorized person to act for you.
- File a privacy complaint without retaliation.
Your choices
For certain uses and disclosures, you may tell us your preferences. Depending on the circumstances and applicable law, these may include sharing information with family or others involved in your care, disaster-relief communications, and certain other uses for which your authorization or opportunity to object is required.
We will obtain your written authorization for uses and disclosures when authorization is required by law, including certain marketing activities, sale of protected health information, and other uses not otherwise permitted by law. You may revoke an authorization in writing to the extent the law permits.
How we may use and disclose your information
HIPAA permits us to use or disclose health information without your written authorization in a number of circumstances, including:
- Treatment: to provide, coordinate, or manage your health care and communicate with other professionals involved in your care.
- Payment: to bill for services, obtain payment, confirm coverage, or complete related payment activities.
- Health care operations: for quality improvement, training, credentialing, compliance, business administration, and other permitted operational activities.
- Public health and safety: when permitted or required for public-health activities, reporting, preventing serious threats to health or safety, or other legally authorized purposes.
- Legal requirements: when required or permitted by law, including certain judicial, administrative, law-enforcement, workers' compensation, oversight, or governmental activities.
- Research: when allowed under applicable privacy and research rules.
- Other permitted purposes: such as responding to organ and tissue donation requests, working with a medical examiner or funeral director, or other disclosures authorized by law.
Additional protections for certain information
Some types of information may receive additional protection under federal or state law. This can include certain psychotherapy notes, substance use disorder treatment records, HIV-related information, genetic information, and other specially protected records. We will follow any law that provides greater privacy protection than the general HIPAA rules. If records maintained by our practice are subject to 42 CFR Part 2, those records are handled in accordance with the additional requirements that apply to them.
Our responsibilities
- We are required by law to maintain the privacy and security of protected health information.
- We will notify affected individuals as required if a breach occurs that may compromise the privacy or security of their information.
- We must follow the duties and privacy practices described in the notice currently in effect.
- We will not use or disclose your information other than as permitted by law or described in this notice unless you authorize us in writing.
Complaints
If you believe your privacy rights have been violated, you may contact our Privacy Officer. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.
Inclusive Behavioral Health PC
11166 Fairfax Boulevard, Suite 401
Fairfax, VA 22030
Phone: 703-505-1251
Email: admin@ibhpsychiatry.com
Changes to this notice
We may change the terms of this notice, and the revised notice may apply to health information we already maintain as well as information we receive in the future. The current notice will be available upon request, at our office, and on this website.
Effective date: September 26, 2026.
This website notice is intended as a practical implementation of the HHS model notice. Before public launch, the practice should confirm that the final notice accurately reflects its actual privacy practices, any services subject to 42 CFR Part 2, and any Virginia, Maryland, or District of Columbia requirements that provide greater protection.