Notice of HIPPA Privacy Practices

Your Rights

You have certain rights regarding your health information. You may:

• Request a paper or electronic copy of your medical record.

• Ask us to correct information in your medical record that you believe is incorrect or incomplete.

• Request that we communicate with you in a specific way or at a specific location.

• Ask us to limit certain uses or disclosures of your health information.

• Request an accounting of certain disclosures of your health information.

• Request a paper copy of this privacy notice at any time.

• Designate an authorized person to act on your behalf, when permitted by law.

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

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HIPAA's access right generally applies to medical and billing records, but psychotherapy notes maintained separately from the medical record are treated differently and are generally excluded from the HIPAA right of access.

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How We May Use and Disclose Your Health Information

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We may use or disclose your protected health information as permitted or required by law, including for:

Treatment
We may use and share your health information to provide, coordinate, and manage your care and treatment.

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Payment
We may use and disclose health information as necessary to bill and receive payment for services provided to you.

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Health Care Operations
We may use and disclose health information for activities necessary to operate the practice, such as quality improvement, administrative activities, compliance, and other health care operations.

As Required or Permitted by Law
We may disclose health information when federal or state law requires or permits us to do so. This may include certain public-health activities, health-oversight activities, legal proceedings, law-enforcement matters, workers' compensation matters, and other legally authorized purposes.

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For uses and disclosures not otherwise permitted by law, we will obtain your written authorization when required. You may revoke an authorization in writing, subject to applicable legal limitations.

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Your Choices

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For certain health information, you may have choices about what we share and with whom we share it. Where your authorization is required, we will obtain it before using or disclosing your information.

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Special federal protections may also apply to certain health information, including qualifying substance-use-disorder treatment records. Special federal protections may also apply to certain health information, including qualifying substance-use-disorder treatment records.

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Our Responsibilities

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Atiles Psychological Network is required to:

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

• Follow the privacy practices described in the current Notice of Privacy Practices.

• Provide you with information about our legal duties and privacy practices.

• Notify you following a breach of unsecured protected health information when notification is required by law.

• Provide an updated notice if our privacy practices materially change.

Questions, Requests, or Complaints

If you have questions about this Notice of Privacy Practices, would like to exercise any of your privacy rights, or believe your privacy rights have been violated, please contact:

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Atiles Psychological Network (APN)
Dr. Ingrid Atiles, Psy.D.
Licensed Clinical Psychologist

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Phone: 407-476-3383
Email: Team@dratiles.com
Website: www.dratiles.com

​You may also file a complaint with the:

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U.S. Department of Health and Human Services
Office for Civil Rights

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HHS provides an online complaint portal as well as options to submit a complaint in writing. HIPAA prohibits retaliation against you for filing a complaint.

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Effective Date

Effective Date: August 15, 2026