THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Cope Well Therapy LLC (the “Practice”) is committed to protecting your privacy. The Practice is required by federal law to maintain the privacy of Protected Health Information (“PHI”), which is information that identifies or could be used to identify you. The Practice is required to provide you with this Notice of Privacy Practices (this “Notice”), which explains the Practice's legal duties and privacy practices and your rights regarding PHI that we collect and maintain.
OUR USES AND DISCLOSURES:
1. Routine Uses and Disclosures of PHI
The Practice is permitted under federal law to use and disclose PHI, without your written authorization, for certain routine uses and disclosures, such as those made for treatment, payment, and the operation of our business, in accordance with HIPAA. The Practice typically uses or shares your health information in the following ways:
To treat you.
• The Practice can use and share PHI with other professionals who are treating you.
• Example: Your primary care doctor asks about your mental health treatment.
To run the health care operations.
• The Practice can use and share PHI to run the business, improve your care, and contact you.
• Example: The Practice uses PHI to send you appointment reminders if you choose.
To bill for your services.
• The Practice can use and share PHI to bill and get payment from health plans or other entities.
• Example: The Practice gives PHI to your health insurance plan so it will pay for your services.
2. Uses and Disclosures of PHI That May Be Made Without Your Authorization or Opportunity to Object
The Practice may use or disclose PHI without your authorization or an opportunity for you to object, including:
To help with public health and safety issues:
• Public health: To prevent the spread of disease, assist in product recalls, and report adverse reactions to medication.
• Required by the Secretary of Health and Human Services: We may be required to disclose your PHI to the Secretary of Health and Human Services to investigate or determine our compliance with the requirements of the final rule on Standards for Privacy of Individually Identifiable Health Information.
• Health oversight: For audits, investigations, and inspections by government agencies that oversee the health care system, government benefit programs, other government regulatory programs, and civil rights laws.
• Serious threat to health or safety: To prevent a serious and imminent threat.
• Abuse or Neglect: To report suspected abuse or neglect of a child, older adult, or dependent adult, or other abuse/neglect when reporting is required or permitted by law.
To comply with law, law enforcement, or other government requests:
• Required by law: If required by federal, state or local law.
• Judicial and administrative proceedings: To respond to a court order, subpoena, discovery request, or other lawful process, when legally permitted or required by applicable law.
• Law enforcement: To help law enforcement locate or identify you, or to disclose information about a victim of a crime.
• Specialized Government Functions: For military or national security concerns, including intelligence, protective services for heads of state, or your security clearance.
• National security and intelligence activities: For intelligence, counterintelligence, protection of the President, other authorized persons or foreign heads of state, for purpose of determining your own security clearance and other national security activities authorized by law.
• Workers' Compensation: To comply with workers' compensation laws or support claims.
To comply with other requests:
• Coroners and Funeral Directors: To perform their legally authorized duties.
• Organ Donation: For organ donation or transplantation.
• Research: For research that has been approved by an institutional review board.
• Business Associates: To organizations that perform functions, activities, or services on the Practice’s behalf, including but not limited to billing, electronic health record, accounting, legal, or technology services, when they have agreed to appropriately protect PHI as required by law.
3. Uses and Disclosures of PHI That May Be Made With Your Authorization or Opportunity to Object
Unless you object, the Practice may disclose PHI:
• To your family, friends, or others if PHI directly relates to that person's involvement in your care.
• If it is in your best interest because you are unable to state your preference.
4. Uses and Disclosures of PHI Based Upon Your Written Authorization
The Practice must obtain your written authorization to use and/or disclose PHI for the following purposes:
• Marketing,
• Sale of PHI, or
• Psychotherapy notes, if maintained, except in limited circumstances permitted by law.
Note: Psychotherapy notes are separate documentation that therapists sometimes keep outside of the main clinical record and that receive special protections under HIPAA. Other PHI and primary clinical documentation — such as progress notes, treatment plans, diagnoses, symptoms, session start and stop times, modalities, medications, and other information used for treatment, payment, or health care operations — are not psychotherapy notes and may be used or disclosed as described in this Notice.
Fundraising:
The Practice does not use or disclose PHI for fundraising communications.
5. Substance Use Disorder Information and Records
The Practice is not a substance use disorder treatment program subject to 42 C.F.R. Part 2. However, the Practice may treat clients whose mental health concerns include substance use issues or diagnoses. Substance-use-related PHI will be treated like other PHI and may be used and disclosed for treatment, payment, and health care operations as described in this Notice, unless a stricter law applies.
If the Practice receives records that are protected by Part 2, the Practice will handle those records with extra protection, as required by applicable law.
6. Other Uses and Disclosures
Other uses and disclosures of PHI not described in this Notice will be made only with your written authorization. The Practice will not use or disclose PHI for any purpose prohibited by HIPAA or other applicable law.
YOUR RIGHTS:
Your rights regarding PHI are explained below. To exercise these rights, please submit a written request to the Practice using the contact information below.
To inspect and copy PHI.
• You can ask for an electronic or paper copy of PHI maintained by the Practice. The Practice may charge you a reasonable, cost-based fee.
• The Practice may deny your request in limited circumstances permitted by law, such as if access is reasonably likely to endanger the life or physical safety of you or another person, or if access to any portion of the requested record is reasonably likely to cause substantial harm to a person. You may have a right to have this decision reviewed.
To amend PHI.
• You can ask to correct PHI you believe is incorrect or incomplete. The Practice may require you to make your request in writing and provide a reason for the request.
• The Practice may deny your request. The Practice will send a written explanation for the denial and allow you to submit a written statement of disagreement.
To request confidential communications.
• You can ask the Practice to contact you in a specific way. The Practice will say “yes” to all reasonable requests.
To limit what is used or shared.
• You can ask the Practice not to use or share PHI for treatment, payment, or business operations. The Practice is not required to agree if it would affect your care.
• If you pay for a service out-of-pocket in full, you may ask the Practice not to share information about that service with your health plan, and the Practice will agree unless disclosure is required by law.
• You can ask for the Practice not to share your PHI with family members or friends by stating the specific restriction requested and to whom you want the restriction to apply.
To obtain a list of those with whom your PHI has been shared.
• You can ask for a list, called an accounting, of the times your health information has been shared. You can receive one accounting every 12 months at no charge, but you may be charged a reasonable fee if you ask for one more frequently.
To receive a copy of this Notice.
• You can ask for a paper copy of this Notice, even if you agreed to receive the Notice electronically.
To 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.
To file a complaint if you feel your rights are violated.
• You can file a complaint by contacting the Practice.
To file a complaint or exercise your rights, contact the practice using the information below:
Cope Well Therapy LLC
Contact: Julie Sokolow, MSW, LCSW
Phone/Text: 856-209-4343
Email: julie@copewelltherapy.com
• You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
• The Practice will not retaliate against you for filing a complaint.
OUR RESPONSIBILITIES:
• The Practice is required by law to maintain the privacy and security of PHI.
• The Practice is required to abide by the terms of this Notice currently in effect. Where more stringent state or federal law governs PHI, the Practice will abide by the more stringent law.
• The Practice reserves the right to amend this Notice. All changes are applicable to PHI collected and maintained by the Practice. If the Practice makes changes to this Notice, you may obtain a revised copy by contacting the Practice using the information above. If applicable, the revised Notice will also be posted on the Practice’s website.
• The Practice will notify you if required by law following a breach of unsecured PHI.
You may revoke your authorization at any time by contacting the Practice in writing, using the information above. The Practice will not use or disclose PHI based on that authorization after it is revoked, except to the extent the Practice has already relied on the authorization.
This Notice is effective on May 10, 2026.