Notice of Privacy Practices

NOTICE OF PRIVACY PRACTICES

Inspirational Therapy LLC

3190 Citrus Tower Blvd, Suite B Clermont, FL 34711

(352) 404-6742

Revised: April 30, 2026

YOUR INFORMATION. YOUR RIGHTS. OUR RESPONSIBILITIES.

This Notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

I. APPLICABILITY OF NOTICE

Protected Health Information (“PHI”) includes any information in your medical record that could identify you, such as your name, address, date of birth, and details about your mental health, therapy sessions, diagnoses, treatment, or services received.

This Notice applies to Inspirational Therapy LLC (“Inspirational Therapy,” “we,” or “us”) and all therapists, clinical staff, employees, independent contractors, and agents working with us. It covers all PHI we create or maintain about you, whether on paper, electronically, or otherwise. This includes records related to individual therapy, couples therapy, family therapy, group therapy, and any behavioral health or counseling services.

Certain records related to substance use disorder (SUD) diagnosis, treatment, or referral have additional federal protections under 42 CFR Part 2 (described in Section VI below).

II. OUR RESPONSIBILITIES

Inspirational Therapy is committed to protecting the privacy and confidentiality of your health information. We are required by law (including HIPAA) to maintain the privacy and security of your PHI. We will notify you promptly if a breach occurs that may compromise your information.

We will follow the practices described in this Notice and provide you with a copy of it. We will not use or share your information except as described here unless you give us written permission. You may change or revoke that permission in writing at any time.

You will be asked to acknowledge receipt of this Notice.

III. YOUR RIGHTS

When it comes to your health information, you have the following rights:

Access Your Records. You may request an electronic or paper copy of your therapy records. We will usually respond within 30 days. We may charge a reasonable, cost-based fee.
Amend Your Records. You may ask us to correct information you believe is incorrect or incomplete. We may deny the request and will explain why in writing within 60 days.
Confidential Communications. You may request that we contact you in a specific way (e.g., only by phone, email, or at a particular address). We will accommodate all reasonable requests.
Request Restrictions. You may ask us to limit how we use or share your information for treatment, payment, or operations. We are not required to agree, except when you pay out-of-pocket in full for a service — we will honor that request unless law requires otherwise.
Accounting of Disclosures. You may request a list of disclosures we have made of your PHI in the past 6 years (one free per year; reasonable fee thereafter).
Copy of This Notice. You may request a paper copy at any time.
Choose a Representative. If you have a legal guardian or medical power of attorney, that person may exercise your rights on your behalf.
File a Complaint. If you believe your rights have been violated, you may contact us or file a complaint with the U.S. Department of Health and Human Services. We will not retaliate against you.

How to Exercise Your Rights

Send written requests to: Inspirational Therapy LLC

Attention: Privacy Officer 3190 Citrus Tower Blvd, Suite B Clermont, FL 34711

Email: patientprivacy@inspirational-therapy.com

IV. YOUR CHOICES

You have the right to instruct us regarding:

Sharing information with family members or others involved in your care
Sharing information in a disaster or emergency

If you are unable to communicate your wishes, we may share information if we believe it is in your best interest or to prevent serious harm.

We Will Never Share Without Your Written Authorization:

Psychotherapy notes (except in limited circumstances)
Your information for marketing purposes
Sale of your PHI
Any other uses and disclosures not described in this Notice

V. HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION

Treatment

We may use and share your PHI with therapists, staff, or other healthcare providers involved in your care.

Healthcare Operations

We may use and share your PHI internally to improve our services, conduct quality improvement, and staff training.

Payment

We may use and share your PHI with your insurance company or other payers to obtain payment for services.

Appointment Reminders and Health-Related Communications

We may contact you by phone, text, email, or mail about appointments or other health-related services.

Psychotherapy Notes

Notes made by your therapist during counseling sessions are kept separate and receive special protection. We will obtain your written authorization before most uses or disclosures of psychotherapy notes, except for limited purposes such as your own treatment, our legal defense, or when required by law.

Other Permitted or Required Disclosures

We may use or disclose your PHI without authorization when:

Required by law (court order, subpoena, etc.)
For public health and safety (reporting abuse, neglect, or imminent harm)
To avert a serious threat to health or safety
For research, workers’ compensation, or government oversight
To law enforcement or coroners/medical examiners as permitted by law

We participate in health information exchanges where permitted by law. You may opt out by notifying us in writing.

VI. SPECIAL PROTECTIONS FOR SUBSTANCE USE DISORDER (SUD) RECORDS

If you receive services related to substance use disorder, those records are protected by 42 CFR Part 2 in addition to HIPAA.

We generally need your specific written authorization to disclose SUD records.
SUD records cannot be used in most legal proceedings without proper authorization or court order.
You may file complaints about misuse of SUD records with us or HHS.

VII. AUTHORIZATIONS

We will obtain your written authorization for any use or disclosure not covered in this Notice. You may revoke an authorization in writing at any time.

VIII. CHANGES TO THIS NOTICE

We reserve the right to change our privacy practices and this Notice. Changes will apply to all PHI we maintain. The revised Notice will be available on inspirational-therapy.com and provided upon request.

IX. CONTACT INFORMATION

Privacy Officer

Inspirational Therapy LLC 3190 Citrus Tower Blvd, Suite B Clermont, FL 34711 Email: patientprivacy@inspirational-therapy.com

You may also file a complaint with: U.S. Department of Health and Human Services Office for Civil Rights 1-877-696-6775 | www.hhs.gov/ocr/privacy/hipaa/complaints/

Website: inspirational-therapy.com

Empower your mind, thrive. Therapy for children, teens & adults.

Notice of Privacy Practices

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