Notice of Privacy Practices

Draft for practice review. Not yet effective. Before adoption, Noema must confirm HIPAA and 42 CFR Part 2 applicability, its actual privacy procedures, and the effective date. This draft does not replace an existing notice supplied to clients.

Prepared September 26, 2026 • Effective date to be set upon adoption

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 is prepared for Noema Integrative Wellness LMHC PLLC and concerns identifiable health information created or maintained in providing care. Georgette Maidiotis, LMHC, is the proposed privacy contact. Website browsing information is described separately in our Website Privacy Policy.

Our responsibilities

We are required to safeguard protected health information, explain our privacy duties, follow the notice currently in effect, and notify affected individuals following a breach of unsecured protected health information as required by law. When New York law or another applicable law provides stronger confidentiality protections, those protections control.

How information may be used or shared

Each use or disclosure below is subject to applicable consent requirements and the additional protections described in this notice.

• Treatment: We use information to assess your needs and provide therapy. For example, information may support treatment planning or, where permitted and appropriately authorized, coordination with another treating professional.
• Payment: Information may be used to bill for care and verify benefits. For example, a claim to your insurer may include your diagnosis, service date, and treatment code.
• Practice operations: Information may support recordkeeping, quality improvement, professional consultation, and administration. For example, a billing service may process a claim under required confidentiality safeguards.

We may contact you about appointments, treatment options, or services related to your care. Vendors supporting clinical records, telehealth, billing, or administration must have appropriate agreements and safeguards where required. A third party paying for therapy does not automatically have a right to your clinical information.

Other disclosures permitted or required by law

Subject to legal conditions and any stricter confidentiality rules, disclosures may be made for mandatory reporting of suspected child abuse or maltreatment; legally authorized public health activities; health oversight, audits, and licensing; serious threats to health or safety; workers’ compensation; specified law enforcement or government functions; legally authorized research; and coroner, medical examiner, funeral director, or organ donation functions. We may also disclose information when otherwise required by law, including to HHS for privacy compliance investigations.

Requests connected with litigation, subpoenas, or court orders are reviewed for applicable privilege, confidentiality, authorization, and procedural requirements. Receiving a subpoena alone does not mean that all therapy records can be released.

Your choices and written permission

Where allowed by law, you may agree or object to sharing relevant information with a person involved in your care or payment. In an emergency or when you cannot express a preference, limited disclosure may be permitted based on professional judgment. Additional consent requirements still apply to specially protected records.

Most uses or disclosures of separately maintained psychotherapy notes require your written authorization, subject to limited legal exceptions. Marketing and disclosures constituting a sale of protected health information require authorization except where an applicable exception permits otherwise. Other uses or disclosures not described here require written authorization. You may revoke an authorization in writing, except to the extent we have already relied on it.

If the practice uses health information for permitted fundraising, you may opt out. If records protected by Part 2 would be used for fundraising, you must first receive a clear opportunity to decline those communications.

Additional confidentiality protections

New York and federal law may impose additional restrictions on mental health, HIV-related, genetic, and substance use information. We will obtain specific consent when required and limit disclosures to what the applicable law allows. General permissions described above do not override these protections.

Substance use records protected by 42 CFR Part 2

To the extent we receive or maintain records protected by Part 2, those records and testimony about their contents cannot be used or disclosed in civil, criminal, administrative, or legislative proceedings against you without your written consent or a qualifying court order issued with the required notice and opportunity to be heard. An authorizing court order must also be accompanied by a subpoena or other legal requirement compelling disclosure.

A HIPAA covered recipient receiving Part 2 records under consent for treatment, payment, and operations may further disclose them as HIPAA permits, subject to the restrictions on proceedings against you. Additional Part 2 consent and notice obligations apply if Noema itself is a Part 2 program. That determination remains pending for this draft.

Your rights

Contact the privacy contact below to make a request. We will explain any written request or identity verification needed and respond within applicable legal time limits.

• Access and copies: Ask to inspect or receive your clinical and billing records in an available paper or electronic format. Limited legal exceptions may apply, including to separately maintained psychotherapy notes. We will explain a denial and any review rights. Only legally permitted copying fees may be charged.
• Corrections: Request an amendment to information you believe is inaccurate or incomplete. If we deny the request, we will explain why in writing and explain how you may submit a statement of disagreement.
• Private communication: Request a reasonable alternative way or place to contact you, such as a different telephone number or mailing address.
• Restrictions: Ask us to limit uses or disclosures. We need not accept every request. If you pay for a service in full yourself and request that it not be disclosed to your health plan for payment or operations, we must honor that restriction unless disclosure is required by law.
• Disclosure history: Request an accounting of qualifying disclosures during the preceding six years. Certain disclosures, including many for treatment, payment, operations, or your authorization, are excluded. The first accounting in a 12 month period is free; we will explain any permitted fee for additional requests.
• A copy of this notice: Request a paper copy even if you previously agreed to electronic delivery.
• A representative: A person with legally recognized authority may exercise applicable rights for you after we verify that authority.

Concerns and complaints

Contact Georgette Maidiotis using the mailing address, phone, or email below to raise a concern or submit a privacy complaint. You may also complain to the U.S. Department of Health and Human Services Office for Civil Rights, by calling 1-877-696-6775, or by writing to 200 Independence Avenue SW, Washington, DC 20201. We will not retaliate against you for filing a complaint.

Changes to this notice

We may revise this notice as permitted by law and apply revised terms to information already maintained as well as information received later. The notice currently in effect will be available on this website and on request. Its effective date will be shown at the top.

Drafting reference: HHS model privacy notices, revised February 2026.