Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.

Our commitment to your privacy
We understand that your health information is personal. We are committed to protecting it and to
providing you with this Notice, which explains your rights and our legal duties regarding your Protected Health Information (“PHI”).

We are required by law to:

• Maintain the privacy of your PHI
• Provide you with this Notice of Privacy Practices
• Follow the terms of this Notice currently in effect
• Notify you if a breach occurs that may have compromised the privacy or security of your
  information

How we may use and disclose your information

• For health-related services:
  We may use and share your PHI with doctors, nurses, pharmacists, and other healthcare professionals involved in your care.
• To bill for our services:
  We may use and disclose your PHI to bill and receive payment from health plans or other entities.
• To run Sunstone:
  • We may use your PHI to run our practice, improve services, and ensure quality care.
  • Other Uses and Disclosures Allowed by Law

We may also use or disclose your PHI without your authorization in situations such as:

• Public health reporting
• Reporting abuse, neglect, or domestic violence
• Health oversight activities
• Legal proceedings and law enforcement requests
• Organ and tissue donation
• Research (under approved protocols)
• To avert a serious threat to health or safety
• Specialized government functions (e.g., military or national security)

We will comply with all additional protections required under Maryland law.

Uses and disclosures requiring your authorization

We will obtain your written permission before using or disclosing your PHI for:

• Marketing communications
• Sale of PHI
• Most uses of psychotherapy notes
• Any other use or disclosure not described in this Notice

You may revoke your authorization at any time in writing.

Your rights regarding your health information

• Right to Access – You may request to see or obtain a copy of your medical record and other
  health information we maintain about you.
• Maryland law limits the fees we may charge for copies of your medical records.
• Right to Request Amendments
• If you believe your information is incorrect or incomplete, you may request a correction.

Right to request restrictions
You may ask us to limit how we use or disclose your PHI. While we are not required to agree, we will comply with certain legally mandated restrictions.

Right to request confidential communications
You may request that we contact you in a specific way (e.g., at a different phone number or mailing
address).

Right to an accounting of disclosures
You may request a list of certain disclosures we have made of your PHI.

Right to a paper copy of this notice
You may request a paper copy of this Notice at any time.

Additional protections required under Maryland Law

• Redisclosure Prohibition
• Maryland law prohibits the person or entity receiving your medical information from redisclosing
  it unless you authorize the redisclosure or the law specifically permits it.
• Minor Consent and Control of Records- Under Maryland law, minors may have the right to
  consent to certain types of treatment (such as mental health, substance use, or reproductive
  health services). When a minor consents to care, the minor generally controls access to those
  records unless Maryland law permits or requires disclosure to a parent or guardian.
• Disclosures to Maryland Oversight Agencies- We may disclose your information to Maryland
  health oversight agencies as permitted by state law, including for licensing, regulatory, or
  investigatory purposes.

Breach Notification
If a breach of your unsecured information occurs, we will notify you in accordance with Maryland and
federal law.

Our Duties
We are required to follow the privacy practices described in this Notice and to notify you if we make
material changes. Updated notices will be posted on our website as required by law. We can change the
terms of this notice, and the changes will apply to all information we have about you.

Disclaimer
No persons shall, on the grounds of race, color, religion, age, sex, national origin, ancestry, sexual
orientation, gender identity or disability, be excluded from participation in, be denied services or
otherwise be subjected to discrimination in the provision of any care or treatment.

Questions or Complaints
If you have questions about this Notice or believe your privacy rights have been violated, you may
contact:

• Email: info@sunstonetherapies.com
• Mail: 9905 Medical Center Drive, Suite 350, Rockville, MD 20850
• Phone: 301-750-3401

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