NOTICE OF PRIVACY PRACTICES
The Well
37 N Hibbert
Mesa, AZ 85201
480-409-5222
Effective Date: August 2026
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
OUR COMMITMENT TO YOUR PRIVACY
Your health information is personal, and The Well is committed to protecting it.
We create and maintain records of the care and services you receive from our practice. These records help us provide quality care and meet our professional and legal responsibilities.
This Notice describes how The Well may use and disclose your protected health information (“PHI”), your rights regarding that information, and our responsibilities for protecting it.
The Well is required by law to:
- Protect the privacy and security of PHI that identifies you.
- Provide you with this Notice explaining our legal duties and privacy practices.
- Follow the terms of the Notice currently in effect.
- Notify you following a breach of unsecured PHI when required by law.
We may change the terms of this Notice as our practices or applicable laws change. Any updated Notice will apply to the health information we maintain and will be available upon request and on our website.
HOW WE MAY USE + DISCLOSE YOUR HEALTH INFORMATION
Treatment
We may use and disclose your health information as permitted by law to provide, coordinate, or manage your treatment.
This may include communication or consultation among clinicians involved in your care, clinical supervision and consultation, coordination with another health care provider, or referrals to other providers.
Because behavioral and mental health information may receive additional protections under federal or Arizona law, we will follow applicable confidentiality requirements when sharing information.
Payment
We may use and disclose your health information as permitted by law for activities necessary to receive payment for the services we provide.
This may include billing, payment processing, determining benefits, or submitting information to a health plan when applicable.
If you pay for a service completely out-of-pocket and request that we not disclose information about that service to your health plan for payment or health care operations, we will honor that request when required by law.
Health Care Operations
We may use or disclose your health information as permitted by law for activities necessary to operate The Well and provide quality care.
These activities may include clinical supervision and consultation, quality improvement, administrative functions, compliance activities, training, credentialing, and other practice operations.
Lawsuits + Legal Proceedings
If you are involved in a lawsuit or legal proceeding, your health information may sometimes be requested through a court order, subpoena, discovery request, or other legal process.
Mental and behavioral health records and communications receive significant confidentiality protections. The Well will disclose information only when authorized or required under applicable federal and Arizona law.
USES + DISCLOSURES THAT GENERALLY REQUIRE YOUR AUTHORIZATION
Psychotherapy Notes
Psychotherapy notes, as specifically defined under HIPAA and maintained separately from the clinical record, receive additional protections.
Most uses or disclosures of psychotherapy notes require your written authorization.
There are limited exceptions permitted by law, including certain uses by the clinician who created the notes, certain training or supervision purposes, legal defense, health oversight, circumstances required by law, and situations involving a serious threat to health or safety.
Marketing
The Well will not use or disclose your PHI for marketing purposes when your authorization is required by law.
Sale of PHI
The Well will not sell your protected health information in the regular course of our business.
Other Uses
Uses and disclosures of your health information not otherwise permitted by law or described in this Notice will generally be made only with your written authorization.
If you provide authorization, you may generally revoke it in writing at any time. Revocation will not affect information already disclosed in reliance on your authorization.
USES + DISCLOSURES THAT MAY NOT REQUIRE YOUR AUTHORIZATION
Subject to applicable federal and Arizona law, The Well may use or disclose PHI without your written authorization in certain circumstances, including:
- When disclosure is required by state or federal law.
- Reporting suspected child abuse, elder abuse, neglect, exploitation, or other circumstances that mental health professionals are legally required to report.
- Preventing or reducing a serious threat to the health or safety of you or another person when disclosure is permitted or required by law.
- Authorized health oversight activities, including audits, licensing matters, or investigations.
- Judicial or administrative proceedings when disclosure is legally authorized or required.
- Certain legally permitted law-enforcement purposes.
- Coroners or medical examiners performing duties authorized by law.
- Workers’ compensation matters as permitted or required by law.
- Certain research activities as permitted by law.
- Certain specialized government functions as permitted by law.
- Appointment reminders and communications about treatment alternatives or health-related services.
When more protective state or federal confidentiality requirements apply to behavioral health information, we will follow those requirements.
FAMILY, FRIENDS + OTHERS INVOLVED IN YOUR CARE
With your permission, or when otherwise permitted by law, we may share relevant health information with a family member, friend, caregiver, or another person involved in your care or payment for your care.
You may object to or limit these disclosures.
In emergency situations or when you are unable to express your preferences, information may be shared when legally permitted and when professional judgment indicates that doing so is in your best interest.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
Request Restrictions
You may ask us not to use or disclose certain PHI for treatment, payment, or health care operations.
We are not required to agree to every request, but we will honor restrictions when required by law.
Request Confidential Communications
You may ask us to communicate with you in a specific way or at a particular location—for example, by calling a particular phone number or sending correspondence to a different address.
We will accommodate reasonable requests.
Access Your Records
You generally have the right to inspect and receive an electronic or paper copy of health information maintained about you, subject to limitations permitted by law.
Psychotherapy notes are treated differently under HIPAA and are not included in the ordinary right of access to the clinical record.
We will respond to requests within the time required by applicable law and may charge a reasonable, cost-based fee when permitted.
Request an Amendment
If you believe information in your health record is incorrect or incomplete, you may ask us to amend it.
We may deny the request in certain circumstances permitted by law. If we do, we will provide the required explanation.
Receive an Accounting of Disclosures
You may request a list of certain disclosures we have made of your PHI.
This accounting does not include every disclosure, such as many disclosures made for treatment, payment, or health care operations, or disclosures you specifically authorized.
Receive a Copy of This Notice
You may request a paper or electronic copy of this Notice at any time, even if you previously agreed to receive it electronically.
Choose Someone to Act for You
If another person has legal authority to make health care decisions or act on your behalf, that person may exercise your privacy rights as permitted by law.
ADDITIONAL PROTECTIONS FOR CERTAIN HEALTH INFORMATION
Certain types of health information may receive additional protections under state or federal law.
Behavioral + Mental Health Information
The Well recognizes the particularly sensitive nature of mental and behavioral health information.
We protect behavioral health records and confidential communications in accordance with applicable federal law and Arizona law.
Substance Use Disorder Records
Certain records relating to substance use disorder treatment may receive additional confidentiality protections, including protections under 42 CFR Part 2.
When those protections apply, The Well will use and disclose those records only as permitted by applicable law.
OUR RESPONSIBILITIES
The Well is required to maintain the privacy and security of your protected health information and to follow the privacy practices described in the Notice currently in effect.
We will notify affected individuals following a breach of unsecured protected health information when required by law.
We will not use or disclose your health information for purposes other than those described in this Notice unless you authorize us in writing or another use or disclosure is permitted or required by law.
If federal or Arizona law provides greater confidentiality protections than HIPAA, we will follow the law that applies to the information and circumstances involved.
QUESTIONS, PRIVACY REQUESTS + COMPLAINTS
If you have questions about this Notice, want to exercise one of your privacy rights, request access to or amendment of your records, or believe your privacy rights have been violated, please contact:
Privacy Officer, The Well
37 N Hibbert
Mesa, AZ 85201
Email: thewellmesa@gmail.com
Phone: 480-409-5222
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.
The Well will not retaliate against you for exercising your privacy rights or filing a complaint.
