Name: Clayton Norman

License Number: Colorado # LPCC.0021124

Contact Information: 970 805 0570/ Clayton@Coloradocreativetherapies.com

Purpose of This Agreement

This HIPAA Privacy and Confidentiality Agreement outlines how your personal health information (PHI) will be used and protected by [Clayton Norman/ Colorado Creative Therapies in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and applicable Colorado state laws.

Your Rights

Under HIPAA, you have the following rights regarding your PHI:

Right to Privacy: You have the right to privacy concerning your health information. Your PHI will be kept confidential and will only be disclosed as permitted or required by law.

Right to Access: You have the right to access and obtain a copy of your health records. You can request amendments to your records if you believe they are inaccurate or incomplete.

Right to Confidential Communications: You may request that communications about your health information be sent to you in a specific manner or at a different location.

Right to Restrict Disclosure: You may request restrictions on how your PHI is used or disclosed for treatment, payment, or healthcare operations.

Right to a Notice of Privacy Practices: You have the right to receive a written notice of our privacy practices, which details how your PHI will be protected and used.

Use and Disclosure of Your PHI

Treatment: Your PHI will be used and disclosed as necessary to provide, coordinate, or manage your therapy and related services.

Payment: Your PHI may be used to obtain payment for therapy services from insurance companies or other third-party payers.

Healthcare Operations: Your PHI may be used for business operations, including quality assessment, training, and legal compliance.

Authorized Disclosures: Your PHI may be disclosed to individuals or entities involved in your care, with your written consent.

Legal Requirements: We may disclose your PHI if required by federal or state law or if ordered by a court of law.

Emergencies: In emergencies, your PHI may be disclosed to appropriate authorities if necessary to protect your health or safety.

Confidentiality in Public Settings
For therapy sessions conducted in public settings, such as Skate Therapy or Nature-Based Therapy, confidentiality cannot be fully guaranteed. While we strive to protect your privacy, conversations and activities in public spaces may be overheard or observed by others.