Intuitive Healing Therapy, PLLC
Essexville, Michigan 48706

Effective Date: February 16, 2026

THIS NOTICE DESCRIBES HOW PSYCHOLOGICAL AND MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule establishes national standards to protect individuals’ medical records and other protected health information (PHI). Intuitive Healing Therapy, PLLC (IHT) is committed to protecting your privacy and confidentiality in accordance with HIPAA, 42 CFR Part 2 (confidentiality of substance use disorder records), and applicable Michigan law.

IHT’S PLEDGE REGARDING HEALTH INFORMATION

IHT understands that health information about you is personal. We create a record of the care and services you receive in order to provide quality care and comply with legal requirements. This notice applies to all records created by this practice.

IHT is required by law to:

• Maintain the privacy of PHI that identifies you

• Provide this Notice of Privacy Practices

• Notify you of a breach of unsecured PHI

• Follow the terms of this notice currently in effect

• Inform you if this notice changes

HOW IHT MAY USE AND DISCLOSE HEALTH INFORMATION

Treatment, Payment, and Health Care Operations

We may use or disclose your PHI without written authorization for treatment, payment, or health care operations. This includes consultation, referrals, coordination of care, billing, and practice management activities.

Substance Use Disorder Information (42 CFR Part 2)

If your record includes information about substance use disorder diagnosis, treatment, or referral for treatment, federal law (42 CFR Part 2) may provide additional protections beyond HIPAA.

In such cases:

• IHT generally may not disclose SUD-related information without your written consent unless permitted by law

• SUD-related records generally may not be used in legal proceedings without your authorization or a court order

• Recipients of SUD information may not redisclose it unless permitted by federal law

These protections apply to SUD information created by IHT or received from other providers.

Lawsuits and Legal Proceedings

We may disclose PHI in response to court or administrative orders or lawful legal processes consistent with HIPAA and Michigan law.

USES AND DISCLOSURES REQUIRING AUTHORIZATION

We obtain written authorization for:

• Psychotherapy notes (with limited legal exceptions)

• Most disclosures of substance use disorder information

• Marketing purposes

• Release of information not otherwise permitted by law

You may revoke authorization in writing at any time.

USES AND DISCLOSURES NOT REQUIRING AUTHORIZATION

We may use or disclose PHI without authorization when permitted or required by law, including:

• Treatment, payment, and operations

• Public health and safety reporting (including suspected child abuse or vulnerable adult abuse under Michigan law)

• Health oversight activities

• Judicial or administrative proceedings

• Law enforcement purposes permitted by law

• Coroners or medical examiners

• Research compliant with privacy protections

• Workers’ compensation

• Appointment reminders or information about services

• De-identified information

DISCLOSURES WHERE YOU MAY OBJECT

We may share PHI with family members or others involved in your care or payment unless you object. In emergencies, we may disclose information if necessary for your care.

YOUR RIGHTS REGARDING YOUR PHI

You have the right to:

• Request limits on uses or disclosures (we may decline)

• Restrict disclosures to insurers when you pay in full out-of-pocket

• Request confidential communications

• Access and obtain copies of your record (excluding psychotherapy notes)

• Request amendment of your record

• Receive an accounting of certain disclosures

• Receive a paper or electronic copy of this notice

• Revoke authorization in writing

MICHIGAN CONFIDENTIALITY PROVISIONS

Michigan law provides additional confidentiality protections for mental health records and certain minor-consented services. When minors legally consent to their own mental health care under Michigan law, parental access to records may be restricted consistent with state law and clinical judgment.

COMPLAINTS

If you believe your privacy rights were violated or disagree with a decision regarding your records, you may contact:

Whitney Wenglikowski, LMSW, CCTP

Intuitive Healing Therapy, PLLC

989-439-0804

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights:

https://www.hhs.gov/ocr/privacy/hipaa/complaints

We will not retaliate against you for filing a complaint.

ACKNOWLEDGMENT

By checking the box below, I acknowledge that I have received and reviewed the Notice of Privacy Practices for Intuitive Healing Therapy, PLLC and understand how my health information may be used and disclosed.