Notice of Privacy Practices 
Your privacy is important to us. We only collect information provided to us by you and with your consent. We only use personal information to ensure effective communication with you and provide services to you.
 Personal Data
The Contact Us page of our website contains a web form that you may choose to use. To complete this form, we may ask you to provide us with certain personally identifiable information that can be used to contact or identify you (“Personal Data”).
Personal identifiable information may include, but is not limited to:
• Email address
• First name and last name
• Phone number with Area Code
• Address
• Other fields Collected form data is not made public.
Form data is protected and accessed by Naturalistic Learning Center LLC employees only.

Notice of Privacy Practices (HIPAA) HIPAA NOTICE OF PRIVACY PRACTICES

As required by the Privacy Regulations Promulgated Pursuant to the Health Insurance Portabiliyand Accountability Act of 1996 (HIPAA).

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 of Privacy Practices describes how we may use and disclose your protected health information (PHI) to carry out treatment, payment or health care operations (TPO) and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.
OUR OBLIGATIONS
We are required by law to:
• Maintain the privacy of protected health information
• Give you this notice of our legal duties and privacy practices regarding health information about you
• Notify affected individuals following a breach of unsecured protected health information
• Follow the terms of our notice currently in effect Uses and Disclosures of Protected Health Information: Your protected health information may be used and disclosed by our organization, our office staff and others outside of our office that are involved in your care and treatment for the purpose of providing health care services to you, payment services, to support the operation of the organization, and any other use required by law.
• Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with a third party. For example, we would disclose your protected health information, as necessary, to a home health agency that provides care to you. For example, your protected health information may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you.
• Payment: Your protected health information will be used, as needed, to obtain payment for your health care services. Examples include: (a) billing and collection activities and related data processing; (b) actions by a health plan or insurer to obtain premiums or to determine or fulfill its responsibilities for coverage and provision of benefits under its health plan or insurance agreement, determinations of eligibility or coverage, adjudication or subrogation of health benefit claims; (c) medical necessity and appropriateness of care reviews, utilization review activities; and (d) disclosure to consumer reporting agencies of information relating to collection of premiums or reimbursement.
• Healthcare Operations: We may use or disclose, as-needed, your protected health information in order to support the business activities of our organization. These activities include, but are not limited to, quality assessment activities, contacting patients with information pertaining to treatment, treatment alternatives, and other information regarding case management, medical review, legal services, and auditing functions, employee review activities, accreditation activities, and conducting or arranging for other business activities. We may use or disclose your protected health information in the following situations without your authorization: as Required By Law, Public Health issues as required by law, Communicable Diseases, Health Oversight, Abuse or Neglect, Food and Drug Administration requirements, Legal Proceedings, Law Enforcement, Criminal Activity, Inmates, Military Activity, National Security, and Workers’ Compensation. Required Uses and Disclosures: Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500. Other Permitted and Required Uses and Disclosures Will Be Made Only with Your Consent, Authorization or Opportunity to Object, unless required by law. You may revoke this authorization, at any time, in writing, except to the extent that your physician or this organization has taken an action in reliance on the use or disclosure indicated in the authorization.

 Your Rights
Following is a statement of your rights with respect to your protected health information.

You have the right to:
• Obtain a copy of your paper or electronic medical record: If the Protected Health Information is not readily producible in the form or format you request, your record will be provided in either our standard electronic format or if you do not want this form or format, a readable hard copy form.
• Correct your paper or electronic medical record: You have a right to inspect and copy Protected Health Information about you that may be used to make decisions about your care or payment for your care. This includes medical and billing records and information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding.
• Request confidential communication: You have the right to request that we communicate with you about medical matters in an alternative way or at a certain location. For example, you can ask that we only contact you on your cell phone or by mail. To request confidential communications, you must make your request, in writing, to Naturalistic Learning Center LLC. Your request must specify how or where you wish to be contacted. We will accommodate reasonable requests.
• Ask us to limit the information we share: You have the right to request a restriction or limitation on the Protected Health Information we use or disclose for treatment, payment, or health care operations. You also have the right to request a limit on the Protected Health Information we disclose to someone involved in your care or the payment for your care, like a family member or friend. To request a restriction, you must make your request, in writing to Naturalistic Learning Center LLC, and identify the information to be restricted, the type of restriction being requested, and to whom the limitation applies. Our organization is not required to agree to a restriction that you may request. If our organization believes it is in your best interest to permit use and disclosure of your protected health information, your protected health information will not be restricted. You then have the right to use another Healthcare Professional. We also are not required to agree to your request unless you are asking us to restrict the use and disclosure of your Protected Health Information to a health plan for payment or health care operation purposes and such information you wish to restrict pertains solely to a health care item or service for which you have paid us “out-of-pocket” in full. If we agree, we will comply with your request unless the information is needed to provide you with emergency treatment.
• Obtain a list of those with whom we’ve shared your information: You have the right to receive an accounting of certain disclosures we have made, if any, of your protected health information.
• Obtain a copy of this privacy notice: You have the right to obtain a paper copy of this notice from us, upon request, even if you have agreed to accept this notice alternatively, e.g., electronically. You may have the right to have our organization amend your protected health information. If we deny your request for amendment, you have the right to file a statement of disagreement with us and we may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal.
• Choose someone to act for you: The personal representative stands in the shoes of the individual and has the ability to act for the individual and exercise the individual’s rights. In general, the scope of the personal representative’s authority to act for the individual under the Privacy Rule derives from his or her authority under applicable law to make health care decisions for the individual. Where the person has broad authority to act on the behalf of a living individual in making decisions related to health care, such as is usually the case with a parent with respect to a minor child or a legal guardian of a mentally incompetent adult, the covered entity must treat the personal representative as the individual for all purposes under the Rule, unless an exception applies. Where the authority to act for the individual is limited or specific to certain health care decisions, the personal representative is to be treated as the individual only with respect to protected health information that is relevant to the representation.
• File a complaint if you believe your privacy rights have been violated: We reserve the right to change the terms of this notice and will inform you by mail of any changes. You then have the right to object or withdraw as provided in this notice. o Complaints: You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated by us. You may file a complaint with us by notifying our privacy contact of your complaint. We will not retaliate against you for filing a complaint. We are required by law to maintain the privacy of, and provide individuals with, this notice of our legal duties and privacy practices with respect to protected health information, if you have any questions concerning or objections to this form, please ask to speak with Mary Beth Bangs, Naturalistic Learning Center HIPAA officer, in person or by phone at 475-204-6410.
• Associated companies with whom we may do business, such as an answering service or delivery service, are given only enough information to provide the necessary service to you. No medical information is provided. We welcome your comments: Please feel free to call us if you have any questions about how we protect your privacy. Our goal is always to provide you with the highest quality services.