Introduction

This Notice describes how medical information about you may be used, disclosed, and how you can access this information. Please review it carefully.

Empower Mental Health and Wellness Clinic (EMHAWC)  (“we,” “us,” “our”) is committed to protecting your Protected Health Information (“PHI”) as required by the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). PHI includes any individually identifiable health information we collect or maintain.

Our Responsibilities

We are required by law to:

• Protect the privacy and security of your PHI.

• Provide this Notice explaining our privacy practices and your rights regarding PHI.

• Notify you promptly of any breach of your unsecured PHI.

Uses and Disclosures That Do Not Require Authorization

We may use or disclose your PHI without your written authorization for:

• Treatment: Sharing information with healthcare providers involved in your care.

• Payment: Sending your PHI to insurance or other entities to obtain payment for services.

• Healthcare Operations: Activities to improve care quality, service, and business management, including third-party service providers under contract to safeguard your PHI.

We may also disclose PHI:

• To public health authorities for disease prevention and control.

• To report abuse, neglect, domestic violence when permitted or required by law.

• For health oversight audits, investigations, and legal proceedings as required.

• To law enforcement, coroners, funeral directors, or organ donation organizations as authorized.

• To family or others involved in your care, limited to relevant information.

• When necessary to avert a serious threat to health or safety.

• For specialized government functions and correctional institutions under applicable laws.

Authorization Required for Other Uses

We will obtain your written authorization for uses not described above, including:

• Uses for marketing purposes.

• Sale of your PHI.

You may revoke any authorization at any time in writing, except for disclosures already made.

Your Rights

You have the right to:

• Request access to your PHI in electronic or paper form.

• Request amendments to your PHI.

• Request confidential communications by alternative means or at alternative locations.

• Request restrictions on certain uses and disclosures of your PHI.

• Receive an accounting of certain disclosures of your PHI in the past six years.

• Obtain a paper copy of this Notice upon request.

Requests should be submitted in writing to our Privacy Officer at:
Privacy Officer
262-764-0049
4003 80th St Suite 103
Kenosha, WI 53142
Email: info@emhawc.com

Changes to This Notice

We reserve the right to change this Notice and apply changes to all PHI we maintain. The updated Notice will be posted on our website with the effective date.

Complaints

For complaints regarding privacy practices, contact our Privacy Officer at the address above or:
Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Website: www.hhs.gov/ocr/privacy/hipaa/complaints/

You will not be retaliated against for filing a complaint

Privacy Policy

Privacy Notice

At Empower Mental Health and Wellness Clinic [EMHAWC], your privacy is important to us. This Privacy Notice explains what information we collect, how we collect and use it, the reasons for collection, and how we share and protect your information. It also outlines your choices regarding your personal information, including how to manage, update, or request deletion.

By using our website and services, you agree to the terms of this Privacy Policy. If you have any questions, please contact us anytime.

Who We Are

[Your Clinic Name] provides healthcare services including telehealth consultations, outpatient care, and therapy services. Our clinical providers (“Providers”) deliver care through various settings.

Health Information

Some information collected may be considered Protected Health Information (“PHI”) under HIPAA. PHI is governed separately by our HIPAA Notice of Privacy Practices, which takes precedence over this Privacy Policy in case of any inconsistency.

Personal Information

What is Personal Information?

Personal information includes any data that can identify you, such as your name, email address, phone number, and other identifying details.

What Information Do We Collect?

• Personal identifiers (name, address, contact details)

• Information related to your health and healthcare interactions

• Account and payment information

• Internet or electronic activity data collected automatically via cookies and analytics tools

• User-generated content you provide

How We Collect Personal Information

We collect information you provide directly, such as when you create an account, consult with Providers, make payments, or contact us. We also collect data automatically as you use our website through technologies like cookies and Google Analytics.

How We Use Your Personal Information

We use your information to:

• Operate and improve our website and services

• Provide healthcare and telehealth services to you

• Communicate important notices about your account and services

• Send you marketing communications if you opt-in

• Comply with legal obligations and enforce our rights

• Aggregate and anonymize data for research and quality improvement

• Respond to lawful requests from authorities

How We Share Your Personal Information

We may share your information with:

• Our affiliates, vendors, and service providers who support our operations

• With your consent or as required by law

• During business transactions such as mergers or acquisitions

• As de-identified data for research or service development

• For marketing purposes, with your consent

Your Choices About Sharing and Tracking

You can manage your preferences regarding cookies, tracking, and marketing communications by:

• Opting out of third-party advertising through NAI and DAA opt-out pages

• Adjusting cookie settings in your browser

• Unsubscribing from promotional emails via the unsubscribe link

Data Security

We implement administrative, technical, and physical safeguards designed to protect your information from unauthorized access or disclosure. However, no internet transmission is completely secure, and any transmission of personal data is at your own risk.

Changes to This Privacy Notice

We may update this Privacy Policy occasionally. Changes will be posted on this page with updated effective dates and prominently on our website’s homepage.

Contact Us

If you have questions or concerns about this Privacy Policy, please contact us at:

[Your Clinic Name]
4003 80th St Suite 103
Kenosha, WI 53142
Phone: 262-764-0049
Email: info@[yourclinic].com

Office Hours: Monday-Friday, 9am - 7pm