Notice of Privacy Practices

Effective Date: 1/1/2026

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

Our Commitment to Your Privacy

Nourish & Thrive Therapy, PC provides home- and community-based pediatric occupational therapy services. In the course of caring for your child, we create and maintain records containing health information — referred to in this Notice as protected health information, or PHI.

We are required by law to maintain the privacy of PHI, to provide you with this Notice describing our legal duties and privacy practices, and to notify you if a breach of unsecured PHI occurs. We are required to follow the terms of the Notice currently in effect.

This Notice applies to all records of your child’s care generated by our practice, whether created by an occupational therapist, a certified occupational therapy assistant, or administrative staff. It is separate from the Privacy Statement on our website, which describes how we handle information collected through nourishandthrivetherapy.com.

How We May Use and Disclose Health Information Without Your Authorization

Treatment

We use and disclose PHI to provide, coordinate, and manage your child’s occupational therapy care. For example, we may share evaluation findings and progress information with your child’s pediatrician, gastroenterologist, feeding team, speech-language pathologist, or other treating providers so that care is coordinated across your child’s team.

Payment

We use and disclose PHI to obtain authorization for services and to bill and collect payment. For example, we may send evaluation reports, treatment notes, and service authorization requests to Regional Center of Orange County, TRICARE West, or your health plan as required to establish medical necessity and receive payment for services provided.

Health Care Operations

We use and disclose PHI to operate our practice and support the quality of care we provide — for example, in clinical supervision of occupational therapy assistants and students, internal quality review, staff training, credentialing, and business management. We may also use PHI to contact you about scheduling, service changes, or practice updates.

Appointment Reminders and Communications

We may contact you by telephone, text message, email, or mail to remind you of scheduled appointments, to confirm or reschedule visits, to coordinate home visit logistics, and to follow up regarding your child’s care.

These communications may include limited health information, such as your child’s first name, the appointment date and time, the location of the visit, and the name of the treating therapist. If we are unable to reach you directly, we may leave a message on voicemail or with the person who answers the telephone.

Standard text message and email are not fully secure methods of communication and may be viewed by others with access to your device or account. By providing a mobile number or email address, you consent to receive these communications. You may withdraw consent for text messages at any time by replying STOP or by notifying our office, and you may request that we communicate with you by alternative means or at an alternative location as described under Your Rights below.

Individuals Involved in Your Child’s Care

Unless you object, we may share information relevant to your child’s care with a family member, caregiver, or other person you identify as involved in your child’s treatment. In an emergency, we may use professional judgment to determine whether such disclosure is in your child’s best interest.

Disclosures Required or Permitted by Law

We may use or disclose PHI without your authorization in the following circumstances:

  • Mandated reporting of child abuse or neglect. As licensed healthcare professionals, our clinicians are mandated reporters under California law and are required to report known or reasonably suspected child abuse or neglect to the appropriate agency.

  • Abuse of an elder or dependent adult. We are similarly required to report suspected abuse of an elder or dependent adult.

  • Serious threat to health or safety. We may disclose PHI when necessary to prevent or lessen a serious and imminent threat to the health or safety of your child or another person.

  • Public health activities. We may disclose PHI to public health authorities for purposes such as preventing or controlling disease, or reporting reactions to medications or problems with products.

  • Health oversight activities. We may disclose PHI to agencies authorized to conduct audits, investigations, inspections, and licensure activities — including the California Board of Occupational Therapy.

  • Judicial and administrative proceedings. We may disclose PHI in response to a court order, subpoena, discovery request, or other lawful process, subject to the additional protections California law provides.

  • Law enforcement. We may disclose PHI to law enforcement officials in limited circumstances specified by law.

  • Workers’ compensation. We may disclose PHI as authorized by workers’ compensation laws.

  • As otherwise required by law. We will disclose PHI when federal, state, or local law requires it.

Uses and Disclosures That Require Your Written Authorization

Uses and disclosures not described in this Notice will be made only with your written authorization. This includes, without limitation:

  • Marketing communications and any use of PHI for marketing purposes.

  • Any sale of PHI. We do not sell protected health information.

  • Photographs, video, and social media. We will not photograph or record your child, or use any image, video, or identifying information about your child on social media, our website, or in any promotional or educational material, without your separate written authorization. Written authorization is required even where your child’s name is not used.

  • Psychotherapy notes, in the limited circumstances where such notes exist.

We do not engage in fundraising and will not use your information for fundraising purposes.

You may revoke a written authorization at any time, in writing, except to the extent we have already acted in reliance on it. Please submit revocations to our Privacy Officer at the address below.

Additional Protections Under California Law

California law, including the Confidentiality of Medical Information Act (CMIA), provides protections in addition to HIPAA and is more restrictive in some areas. Where California law affords greater privacy protection than federal law, we follow California law. In practice, this means we require your written authorization for certain disclosures that federal law alone might permit.

California law also gives minors the right to control their own health information in limited circumstances involving specific categories of care. Occupational therapy services are not among these categories, and a parent or legal guardian ordinarily exercises the rights described in this Notice on behalf of a minor child.

Parents, Guardians, and Personal Representatives

Because our clients are infants and children, the rights described in this Notice are generally exercised by a parent or legal guardian acting as the child’s personal representative. We may request documentation of guardianship, custody, or authority to act on a child’s behalf.

In situations involving separated or divorced parents, we follow California law regarding parental access to a child’s health records. Absent a court order limiting access, either parent may generally exercise these rights. If a court order restricts a parent’s access to records or to the child, please provide us with a copy so that we can honor it.

We may decline to treat a person as a personal representative if we reasonably believe doing so would endanger the child, consistent with applicable law.

Your Rights Regarding Your Child’s Health Information

Right to Inspect and Obtain a Copy

You have the right to inspect and obtain a copy of your child’s health records, including an electronic copy if we maintain the records electronically. Submit your request in writing to our Privacy Officer. We will respond within the timeframes required by law and may charge a reasonable, cost-based fee. In limited circumstances we may deny a request, and you may have the right to have that denial reviewed.

Right to Request an Amendment

If you believe information in your child’s record is incorrect or incomplete, you may request in writing that we amend it, including your reason for the request. We may deny the request if the information was not created by us, is not part of the records we maintain, or is accurate and complete. If we deny your request, you may submit a statement of disagreement to be included in the record.

Right to an Accounting of Disclosures

You have the right to request a list of certain disclosures of PHI we have made, other than disclosures for treatment, payment, health care operations, and certain other exceptions. Your request must state a time period of up to six years. The first accounting in any twelve-month period is provided free of charge.

Right to Request Restrictions

You have the right to request that we limit how we use or disclose PHI for treatment, payment, or health care operations, or to a person involved in your child’s care. We are not required to agree to a requested restriction, except in one circumstance described below. If we do agree, we will honor the restriction unless the information is needed to provide emergency treatment.

Out-of-pocket restriction. We are required to agree to your request that we not disclose PHI to a health plan for purposes of payment or health care operations when the service has been paid for in full, out of pocket, by you or on your behalf.

Right to Request Confidential Communications

You have the right to request that we communicate with you about health matters in a particular way or at a particular location — for example, by email only, at a specific telephone number, or with no message left on voicemail. We will accommodate reasonable requests and will not ask you to explain the reason for the request.

Right to a Paper Copy of This Notice

You have the right to a paper copy of this Notice at any time, even if you have agreed to receive it electronically. A current copy is also posted on this website.

Right to Notification of a Breach

You have the right to be notified in the event of a breach of unsecured protected health information involving your child’s records.

Right to Choose Someone to Act for You

You may designate another person to act on your behalf with respect to your child’s health information. We will require written documentation of that authority.

Our Legal Duties and Changes to This Notice

We are required by law to maintain the privacy of PHI, to provide this Notice of our legal duties and privacy practices, to follow the terms of the Notice currently in effect, and to notify affected individuals following a breach of unsecured PHI.

We reserve the right to change this Notice, and to make the revised Notice effective for all PHI we maintain, including information created or received before the change. When we make a material change, we will post the revised Notice on our website, make copies available at your request, and provide it at your next visit.

Questions and Complaints

If you have questions about this Notice, or if you believe your privacy rights have been violated, please contact our Privacy Officer:

Jane Moore, OTR/L, SWC, CLC, CKTP

Privacy Officer · Nourish & Thrive Therapy, PC

Ladera Ranch, CA 92694

Phone: 949-840-8701

Fax: 949-379-8701

Email: jane@nourishandthrivetherapy.com

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights: 200 Independence Avenue SW, Washington, D.C. 20201 · Toll-free 1-877-696-6775 · hhs.gov/ocr/privacy/hipaa/complaints

You may also file a complaint with the California Department of Justice or the California Board of Occupational Therapy.

We will not retaliate against you in any way for filing a complaint, and filing a complaint will not affect your child’s care.