Notice of Privacy Practices
Effective Date: August 1, 2026
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.
ClearLane Behavioral Health is committed to protecting the privacy and security of your health information. This Notice of Privacy Practices explains how we may use and disclose your protected health information (“PHI”), your rights regarding that information, and our responsibilities under applicable federal and state privacy laws.
Your Health Information
Protected health information includes information about your physical or mental health, healthcare services, treatment, diagnoses, medications, payment for healthcare, and other information that identifies you or could reasonably be used to identify you.
How We May Use and Disclose Your Health Information
Treatment
We may use and disclose your health information to provide, coordinate, or manage your healthcare.
For example, we may share relevant information with another healthcare professional involved in your treatment, such as your primary care provider, therapist, pharmacy, laboratory, specialist, or another treating clinician, when permitted by law.
Payment
We may use and disclose health information as necessary to obtain payment for services provided to you.
For example, we may provide information to your health insurance plan for eligibility verification, claims submission, prior authorization, utilization review, or payment purposes.
Healthcare Operations
We may use and disclose your health information as necessary to operate our practice and improve the quality of care we provide.
These activities may include quality assessment, compliance activities, credentialing, training, auditing, business planning, administrative functions, and reviewing the effectiveness of our services.
We may also work with third-party service providers that perform functions on our behalf. When required by law, these organizations are considered business associates and are required to appropriately safeguard your protected health information.
Appointment and Treatment Communications
We may use your contact information to communicate with you about appointments, scheduling, treatment, prescriptions, laboratory testing, billing, insurance, administrative matters, or other healthcare-related services.
Communications may occur through telephone, voicemail, secure patient portal, email, text message, or other communication methods consistent with your preferences and applicable law.
Other Uses and Disclosures Permitted or Required by Law
We may use or disclose health information without your written authorization when permitted or required by law. Depending on the circumstances, this may include disclosures for:
Public health and safety activities, including disease prevention, medication or product safety matters, and reporting certain adverse events.
Reporting suspected abuse, neglect, exploitation, or domestic violence when required or permitted by law.
Preventing or reducing a serious and imminent threat to the health or safety of you or another person.
Health oversight activities authorized by law, including audits, investigations, inspections, licensing, credentialing, and regulatory activities.
Workers’ compensation or similar programs as permitted by applicable law.
Certain law-enforcement or governmental purposes when the requirements of applicable law have been satisfied.
Judicial or administrative proceedings when disclosure is authorized or required under applicable law.
Coroners, medical examiners, and funeral directors when permitted by law.
Organ and tissue donation organizations when applicable.
Research when permitted by law and when all applicable privacy requirements have been met.
The U.S. Department of Health and Human Services when necessary to demonstrate our compliance with federal privacy requirements.
Other circumstances in which federal or state law requires or specifically permits disclosure.
Mental Health and Psychotherapy Information
Certain mental health information may receive additional protection under federal or state law.
Most uses and disclosures of separately maintained psychotherapy notes require your written authorization, except in limited circumstances permitted by law.
Where applicable state law provides greater privacy protections for mental health records or other sensitive health information, ClearLane Behavioral Health will follow the more protective requirement.
Substance Use Disorder Records — 42 CFR Part 2
Certain records relating to substance use disorder treatment may be protected by additional federal confidentiality requirements under 42 CFR Part 2, in addition to HIPAA.
When Part 2 applies to your records, ClearLane Behavioral Health will use and disclose those records only as permitted by applicable law.
Part 2 records generally may not be used or disclosed in a civil, criminal, administrative, or legislative investigation or proceeding against you based on the content of those records unless you provide the required consent or the disclosure is authorized by an appropriate court order and accompanying legal process as required by federal law.
Additional restrictions may apply even when another type of health information could otherwise be disclosed under HIPAA.
Information Requiring Your Authorization
We will obtain your written authorization before using or disclosing your health information when an authorization is required by law.
This generally includes:
Most uses and disclosures of psychotherapy notes
Certain marketing activities
The sale of protected health information
Other uses or disclosures not otherwise permitted by this Notice or applicable law
If you give us written authorization, you may revoke that authorization in writing at any time. Your revocation will not affect disclosures that were already made in reliance on your authorization before we received the revocation.
Your Rights Regarding Your Health Information
Access Your Medical Record
You have the right to inspect or request an electronic or paper copy of health information maintained about you, subject to certain limited exceptions.
We generally will respond to your request within the timeframe required by law. A reasonable, cost-based fee may apply when permitted.
Request a Correction
If you believe information in your medical record is incorrect or incomplete, you may ask us to amend it.
We may deny your request in certain circumstances, but if we do, we will provide an explanation as required by law.
Request Confidential Communications
You may ask us to communicate with you in a particular way or at a particular location.
For example, you may request that we contact you only through a particular telephone number or email address. We will accommodate reasonable requests.
Request Restrictions
You may ask us not to use or disclose certain health information for treatment, payment, or healthcare operations.
We are not required to agree to every requested restriction unless the law requires us to do so.
If you pay for a healthcare service completely out of pocket, you may request that we not disclose information regarding that service to your health plan for payment or healthcare operations purposes. We will honor such a request when required by law unless disclosure is otherwise required.
Receive an Accounting of Disclosures
You may request a list of certain disclosures of your health information made during the six years before your request.
The accounting will not include certain disclosures excluded by law, such as many disclosures for treatment, payment, or healthcare operations.
Receive a Copy of This Notice
You may request a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.
The current Notice is also available on our website.
Choose a Personal Representative
If another person has legal authority to act on your behalf, such as a legal guardian, healthcare agent, or person holding appropriate power of attorney, that individual may exercise your privacy rights as permitted by law.
We may require documentation establishing that authority before releasing information or taking action on a request.
Family Members and Others Involved in Your Care
You may tell us whether you want information shared with family members, friends, caregivers, or other people involved in your care or payment for your care.
When permitted by law, we may share limited information relevant to that person’s involvement in your care.
If you are unable to communicate your preferences, we may use professional judgment to make certain disclosures when permitted by law and when we believe doing so is in your best interest.
Additional restrictions may apply to specially protected information, including certain mental health and substance use disorder records.
State and Other Privacy Protections
ClearLane Behavioral Health provides services in more than one state. Federal law establishes important privacy protections, but state law may provide additional or more stringent protection for certain categories of health information.
This may include information relating to mental health treatment, substance use disorder treatment, communicable diseases, HIV-related information, genetic information, minors, or other specially protected information.
When a federal or state law applicable to your care provides greater privacy protection than HIPAA, ClearLane Behavioral Health will follow the more protective requirement. When written authorization is required by applicable law before specially protected information may be released, we will obtain that authorization unless another provision of law permits or requires the disclosure.
Our Responsibilities
ClearLane Behavioral Health is required by law to maintain the privacy and security of your protected health information.
We are required to provide you with this Notice describing our legal duties and privacy practices and to follow the terms of the Notice currently in effect.
We will take reasonable administrative, technical, and physical measures to safeguard your health information.
If a breach occurs involving unsecured protected health information and notification is required by law, we will notify affected individuals as required.
We will not use or disclose your health information in a manner not described in this Notice unless you authorize us to do so or the use or disclosure is otherwise permitted or required by law.
Changes to This Notice
ClearLane Behavioral Health may change the terms of this Notice and our privacy practices.
Any revised Notice may apply to health information we already maintain as well as information we receive in the future, as permitted by law.
The current version of this Notice will be available on our website and upon request.
Questions or Privacy Concerns
If you have questions about this Notice, would like to exercise one of your privacy rights, or have concerns regarding the privacy of your health information, please contact:
Privacy Officer
ClearLane Behavioral Health
Email: info@clearlanebehavioralhealth.com
Phone: (813) 444-2276
Website: clearlanebehavioralhealth.com
Filing a Privacy Complaint
If you believe your privacy rights have been violated, you may file a complaint directly with ClearLane Behavioral Health using the contact information above.
You may also file a complaint with:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775
Information about filing a complaint is available through the U.S. Department of Health and Human Services Office for Civil Rights.
If your complaint involves records protected by 42 CFR Part 2, complaints regarding potential violations of those confidentiality requirements may also be submitted to the HHS Office for Civil Rights.
ClearLane Behavioral Health will not retaliate against you for filing a privacy complaint or exercising any of your privacy rights.