Notice of Privacy Practices

Effective Date: May 6, 2026

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

Your Rights

You have the right to:

• Get a copy of your paper or electronic medical record.
• Correct your paper or electronic medical record.
• Request confidential communication.
• Ask us to limit the information we share.
• Get a list of those with whom we’ve shared your information.
• Get a copy of this privacy notice.
• Choose someone to act for you.
• File a complaint if you believe your privacy rights have been violated.

Your Choices

You have some choices in the way that we use and share information as we:

• Tell family and friends about your condition.
• Provide disaster relief.

Our Uses and Disclosures

We may use and share your information as we:

• Treat you.
• Run our organization.
• Bill for your services.
• Help with public health and safety issues.
• Comply with the law.
• Address workers’ compensation, law enforcement, and other government requests.
• Respond to lawsuits and legal actions.

Questions and Complaints

If you have questions about this notice, please contact Dr. Hannah Versino at 317.324.8591. If you believe your privacy rights have been violated, you can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.