Notice of Privacy Practices
Effective Date: 09/29/2026
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.
This Notice applies to Bravo Mind Psychiatry PLLC. It explains our duties and your rights regarding protected health information (PHI). PHI includes information about your health, treatment, payment for care, and other information that identifies you and is protected by applicable privacy law.
Questions about this Notice or your privacy rights:
Bravo Mind Psychiatry PLLC
4405 7th Ave SE, STE 200, Lacey, WA 98503-1055
Office Phone: 210-201-2656
Website: www.bravomindpsychiatry.com
Your Information. Your Rights. Our Responsibilities.
You have rights regarding your health information. This Notice explains those rights, the choices you may have about how information is shared, and the ways we may use or disclose information as permitted or required by law.
Your Rights
Get a copy of your medical record
You may ask to see or obtain an electronic or paper copy of your medical record and other health information we maintain about you. We generally respond within the time required by law and may charge a reasonable, cost-based fee when permitted.
Ask us to correct your record
You may ask us to amend health information you believe is incorrect or incomplete. We may deny the request in some circumstances, but we will explain the reason in writing as required by law.
Request confidential communications
You may ask us to contact you in a specific way or at a different address. We will accommodate reasonable requests.
Ask us to limit what we use or share
You may ask us not to use or disclose certain information for treatment, payment, or health care operations. We are not always required to agree. If you pay for a service in full out of pocket, you may ask us not to disclose information about that service to your health plan for payment or health care operations, and we will honor the request unless disclosure is required by law.
Get an accounting of certain disclosures
You may request a list of certain disclosures of your health information made during the period allowed by law. The accounting does not include every type of disclosure, such as many disclosures for treatment, payment, or health care operations.
Get a paper copy of this Notice
You may ask for a paper copy of this Notice at any time, even if you received it electronically.
Choose someone to act for you
If a person has legal authority to act as your personal representative, that person may exercise your privacy rights as permitted by law. We may verify that authority before acting on a request.
File a complaint
You may complain to Bravo Mind Psychiatry PLLC if you believe your privacy rights have been violated. 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.
Your Choices
For certain uses and disclosures, you may tell us your preferences. Depending on the circumstances and applicable law, you may have a choice about whether we:
Share information with family members, close friends, or others involved in your care or payment for your care.
Share information in a disaster relief situation.
Use information for certain communications where your authorization or opportunity to agree or object is required. We generally will not use or disclose your information for marketing, sell your health information, or disclose most psychotherapy notes without your written authorization, except where the law allows otherwise. Bravo Mind Psychiatry PLLC does not currently use PHI for fundraising.
How We Typically Use or Share Health Information
Treat you
We may use your health information and share it with other health care professionals involved in your treatment or care coordination.
Run our practice
We may use and share health information to operate the practice, manage your care, improve services, conduct quality activities, and contact you when necessary.
Bill for services
We may use and share health information to bill and obtain payment from health plans, patients, guarantors, or other responsible parties.
Other Uses and Disclosures Permitted or Required by Law
We may use or disclose health information in other circumstances when applicable legal
requirements are met, including:
- Public health and safety activities, such as reporting certain diseases, adverse events, suspected
abuse or neglect, or addressing certain serious threats to health or safety.
- Health oversight activities authorized by law.
- Research when legal requirements for the use or disclosure are satisfied.
- Compliance with federal, state, or local law and with lawful requests from government agencies.
- Workers’ compensation and similar programs as authorized by law.
- Certain law enforcement requests and special government functions as permitted by law.
- Medical examiners, coroners, or funeral directors when permitted or required by law.
- Judicial and administrative proceedings, including valid court orders, subpoenas, or other legal
process, subject to applicable protections.
Mental Health, Minor-Consent, and Other Specially Protected Information
Federal and state laws may provide additional privacy protections for certain information, including
mental health records, services to which a minor may consent, substance use disorder records, HIV
or sexually transmitted infection information, genetic information, and other specially protected
records. When a law provides greater privacy protection than HIPAA, we will follow the more
protective law.
For Washington patients, additional state-law protections may apply to behavioral health
information and to care for which an adolescent is legally authorized to consent. For Texas patients,
additional state-law confidentiality protections may apply to mental health records. Parent or
guardian access to a minor’s information depends on the minor’s age, the type and circumstances of
care, legal decision-making authority, and applicable law.
Substance Use Disorder Records Subject to 42 CFR Part 2
To the extent Bravo Mind Psychiatry PLLC creates, receives, or maintains substance use disorder
patient records that are subject to 42 CFR Part 2, those records receive additional federal protections.
We will not use or disclose Part 2 records in civil, criminal, administrative, or legislative
investigations or proceedings against you unless permitted by your written consent or by a
qualifying court order and subpoena, as required by law.
Our Responsibilities
- We are required by law to maintain the privacy and security of your protected health
information.
- We will notify you as required by law if a breach occurs that may have compromised the privacy
or security of your information.
- We must follow the duties and privacy practices described in the Notice currently in effect and
provide you with a copy of this Notice.
- We will not use or disclose your information other than as described in this Notice unless you
authorize us in writing or another law permits or requires the use or disclosure. You may revoke
a written authorization as permitted by law.
Changes to the Terms of This Notice
We may change the terms of this Notice. Changes may apply to all health information we maintain,
including information created or received before the change. The current Notice will be available
upon request and posted on our website.
How to File a Privacy Complaint
You may contact the Bravo Mind Psychiatry PLLC Privacy Officer using the contact information
above. You may also file a complaint with the U.S. Department of Health and Human Services Office
for Civil Rights by visiting www.hhs.gov/hipaa/filing-a-complaint, calling 1-877-696-6775, or writing
to 200 Independence Avenue, S.W., Washington, D.C. 20201. We will not retaliate against you for
filing a complaint.
Copies and access. You may request a paper copy of this Notice at any time. The current Notice is
also available on the Bravo Mind Psychiatry PLLC website. Patient access to available health
information may also be provided through the practice’s patient portal when applicable.
Effective Date: September 29, 2026