Notice of Privacy Practices

Effective date: November 3, 2026

Our responsibilities

• We are required by law to keep your protected health information private and secure.
• We must give you this notice of our legal duties and privacy practices, and follow the terms of the notice currently in effect.
• We will tell you promptly if a breach occurs that may have compromised the privacy or security of your information.
• We will not use or share your information other than as described here unless you tell us we can in writing. You may change your mind at any time by letting us know in writing.

How we may use and share your health information

We typically use or share your health information in the following ways:

• To treat you. We may use your information and share it with other professionals who are treating you. For example, a provider here may share information with your primary care doctor or a physical therapist.
• To bill for your services. We may use and share your information to bill and get payment from health plans or other entities. For example, we give information about your visit to your health insurance plan so it will pay for your care.
• To run our practice. We may use and share your information to run our practice, improve your care and contact you when necessary, such as to remind you of an appointment.

Other ways we may use or share your information

We are allowed or required to share your information in other ways, usually in ways that contribute to the public good. We have to meet many conditions in the law before we can share your information for these purposes.

• As required by law, including with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law.
• For public health and safety, such as preventing disease, reporting adverse reactions to medications, reporting suspected abuse, neglect or domestic violence, and preventing or reducing a serious threat to anyone's health or safety.
• For health oversight activities authorized by law, such as audits, investigations and inspections.
• For lawsuits and legal actions, in response to a court or administrative order, or in response to a subpoena.
• For law enforcement purposes or with a law enforcement official, as permitted by law.
• For workers' compensation claims, as authorized by workers' compensation laws.
• For special government functions, such as military, national security and presidential protective services, and with correctional institutions for people in custody.
• With medical examiners, coroners and funeral directors, and with organ procurement organizations.
• For research, when the research meets the privacy safeguards required by law.
• With business associates who perform services for us, such as billing, under written agreements that require them to protect your information.

Your choices

For certain information, you can tell us your choices about what we share. In these cases, you have both the right and choice to tell us to:

• Share information with your family, close friends or others involved in your care, or in payment for your care.
• Share information in a disaster relief situation.

If you are not able to tell us your preference, for example if you are unconscious, we may share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

We never share your information for marketing purposes or sell your information unless you give us written permission. Most sharing of psychotherapy notes also requires your written permission.

Substance use disorder treatment records

If we receive records about you from a federally assisted substance use disorder treatment program, those records have additional protection under federal law (42 CFR Part 2). We will not use or share those records, or testimony about their content, in any civil, criminal, administrative or legislative proceeding against you unless you give written consent or a court orders it after giving you notice and an opportunity to be heard, as the law requires.

Your rights

When it comes to your health information, you have certain rights.

• Get a copy of your medical record. You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. We will provide a copy or a summary, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
• Ask us to correct your record. You can ask us to correct health information you think is incorrect or incomplete. We may say no, but we will tell you why in writing within 60 days.
• Request confidential communications. You can ask us to contact you in a specific way, for example by home or office phone, or to send mail to a different address. We will say yes to all reasonable requests.
• Ask us to limit what we use or share. You can ask us not to use or share certain information for treatment, payment or our operations. We are not required to agree, and we may say no if it would affect your care. If you pay for a service or health care item out of pocket in full, you can ask us not to share that information with your health insurer for payment or our operations, and we will say yes unless a law requires us to share it.
• Get a list of those we've shared information with. You can ask for a list of the times we've shared your health information for six years prior to the date you ask, who we shared it with and why. It will include all disclosures except those about treatment, payment and health care operations, and certain others, such as any you asked us to make. We will provide one list a year for free, but may charge a reasonable, cost-based fee if you ask for another within 12 months.
• Get a copy of this notice. You can ask for a paper copy of this notice at any time, even if you have agreed to receive it electronically.
• Choose someone to act for you. If you have given someone medical power of attorney, or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority before we take any action.
• File a complaint if you feel your rights are violated. You can complain to us using the contact information below, or to the U.S. Department of Health and Human Services Office for Civil Rights by writing to 200 Independence Avenue S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting hhs.gov/ocr/complaints (opens in a new tab). We will not retaliate against you for filing a complaint.

State law

Pennsylvania law may give certain types of information, such as information about HIV status, mental health treatment and drug or alcohol treatment, more protection than federal law. When it does, we follow the stricter law.

Changes to this notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available on request, in our office and on our website.

Contact us

To use any of these rights, ask a question or file a complaint, contact our Privacy Officer:

Privacy Officer
Advance Pain Management & Wellness Center
4811 Jonestown Road, Suite 123
Harrisburg, PA 17109
Phone: (717) 297-6668

You may also request a paper copy of this notice at our front desk.