Notice of HIPAA Privacy Practices

Effective date: November 5, 2026

Covered healthcare practice: Create Outcomes Psychological Assessments, PLLC (the “Practice”). This notice applies to protected health information (PHI) maintained by this Practice in connection with treatment, payment, and healthcare operations. Other Create Outcomes-affiliated healthcare practices may provide their own applicable notice. Holding Mental Health Technologies, LLC operates website technology and is not identified here as the healthcare practice providing your treatment.

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS IT. PLEASE REVIEW IT CAREFULLY.

You have the right to receive a paper or electronic copy of this notice and discuss it with our Privacy Officer, Michael Pollet, by calling (866) 232-7328 or emailing info@createoutcomes.com.

Your rights

Get a copy of your records. You may inspect or request an electronic or paper copy of health information in your designated record set. We generally respond within 30 days, with extensions when permitted by law, and charge only legally permitted fees. Separately maintained psychotherapy notes are subject to special protections.

Ask us to correct your records. You may request an amendment if information is inaccurate or incomplete. We will explain a denial and any related rights.

Request confidential communications. You may ask us to contact you through a specific reasonable method or at a particular location. We will honor reasonable requests.

Ask us to limit sharing. You may request restrictions on use or disclosure for treatment, payment, or operations. We do not always have to agree. If you pay in full out of pocket for a service and request that we not disclose information about that service to your health plan for payment or operations, we will honor that request unless disclosure is required by law.

Get an accounting of disclosures. You may ask for an accounting of certain disclosures over the preceding six years. Some disclosures, including many related to treatment, payment, and operations, are excluded by law. One accounting within a 12-month period is generally free.

Receive a copy of this notice; designate a representative. You may request a paper copy at any time, and a legally authorized personal representative may exercise your rights as permitted by law.

File a complaint. Contact our Privacy Officer or the U.S. Department of Health and Human Services Office for Civil Rights at https://www.hhs.gov/hipaa/filing-a-complaint/index.html. We will not retaliate against you for exercising your rights or making a complaint.

How we may use or disclose information

Treatment. We may use and disclose information to provide mental health treatment; coordinate care, referrals, supervision, and consultation; and communicate with other healthcare professionals, subject to any more protective law.

Payment. We may use and disclose information for eligibility checks, claims, billing, and payment administration.

Healthcare operations. We may use and disclose information for permitted quality improvement, clinical training, credentialing, auditing, and management activities.

Other legally permitted or required uses. Depending on the circumstances and applicable law, disclosures may be permitted or required for public health or safety, abuse or neglect reporting, lawful oversight, workers' compensation, medical examiners, law enforcement, research subject to safeguards, certain government functions, and judicial or administrative proceedings. A subpoena or legal request does not automatically override mental health confidentiality or evidentiary privileges. We will evaluate applicable requirements before disclosing information.

We may contact you with appointment reminders and information about healthcare services or treatment alternatives as permitted by law.

Choices and uses requiring authorization

You may tell us whether to share information with family, friends, or others involved in your care or payment, and we will follow your choices as required by law. Limited sharing may be permitted if you cannot state a preference, in an emergency, or to prevent a serious and imminent threat.

We generally require your written authorization for marketing uses, sale of PHI, and most uses or disclosures of separately maintained psychotherapy notes, except where a specific legal exception applies. We do not sell PHI. We do not use PHI for marketing in a way that requires authorization without obtaining it. You may revoke a written authorization, subject to actions already taken under it.

Substance use disorder records received from other providers

The Practice does not operate a federally assisted substance use disorder treatment program subject to 42 CFR Part 2. We may nevertheless receive information from other providers that is protected under Part 2. When we hold such records, additional restrictions may apply to their use and disclosure. Part 2 records generally cannot be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you without your specific written consent or a qualifying court order and subpoena or comparable legal mandate. If we use Part 2 information for fundraising, we will provide any required advance notice and choice.

Additional New York, Colorado, and Oregon protections

HIPAA is not the only rule protecting mental health information. New York recognizes statutory privileges for confidential communications with qualifying psychologists and social workers and imposes additional confidentiality requirements in circumstances governed by state mental health law. Colorado recognizes psychotherapist–patient privileges and has additional statutory protections for certain behavioral health records and services. Oregon protects confidential psychotherapist–patient communications and affords additional rights and duties under its health-information confidentiality statutes. Specific exceptions and permissions differ by profession, setting, type of record, and applicable law. We apply stricter state or federal restrictions when they govern a particular disclosure.

Our responsibilities

We must maintain the privacy and security of PHI, follow this notice, and notify affected individuals when a breach notification is required. We use reasonable safeguards and share information only as permitted or required by applicable law. We may revise this notice, with changes applying to PHI we already maintain. The current notice will be available on our website, at our offices, and upon request. We make a good-faith effort to obtain written acknowledgment of receipt when required; acknowledgment does not waive privacy rights.

Privacy contact

Michael Pollet, Privacy Officer
22 Oakwood Road, Huntington, NY 11743
info@createoutcomes.com
(866) 232-7328

For therapy services, see the Notice of HIPAA Privacy Practices for Create Outcomes Psychological Services.