Valentine PsychiatryDr. Jessee Valentine, DO, FAPA 610-CARE-888 (610-227-3888)

Legal

Notice of Privacy Practices

Effective Date: September 27, 2026

Valentine Psychiatry, PC

150 S. Warner Rd, Suite 130, King of Prussia, PA 19406 | (610) 227-3888 | valentinepsychiatry.com

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.

Overview

This HIPAA Notice of Privacy Practices (the “Notice”) will tell you about the ways Valentine Psychiatry, PC and the licensed health care professionals providing professional services through the practice (collectively the “Practice,” “we,” “us,” and “our”) may use and disclose health information about you. This Notice will also describe your rights and certain obligations that we have regarding the use and disclosure of your health information. This Notice applies only to health information that is “protected health information” as defined by HIPAA. It does not apply to information that is not covered by HIPAA. Please see the Practice’s Website Privacy Policy for terms that apply to information collected through our website and other non-HIPAA covered products and services.

We are required by law to: make sure that health information that identifies you is kept private; give you this Notice of our legal duties and privacy practices with respect to your health information; notify you following a breach of your unsecured protected health information; and follow the terms of the Notice that is currently in effect. Although this Notice is being provided to you electronically, and by signing an acknowledgment of receipt of this Notice you consent to its provision electronically, you have the right to request a paper copy of this Notice at any time. We reserve the right to change our privacy practices and the terms of this Notice at any time and to make any updated or new Notice provisions effective for all protected health information that we maintain, including health information collected before the effective date of the change. Any revised Notice will be posted on our website and available at our office.

How Your Information Is Used

We may use and disclose your health information for treatment, payment, and health care operations. These activities are necessary to provide you with quality care, and state and federal laws allow us to use and disclose your health information for these purposes, subject to the additional state-law protections described below. For example:

  • Treatment. We may use your health information to evaluate you, prescribe medication, and provide psychotherapy, and we may share it with other providers involved in your care, such as your therapist, primary care physician, or pharmacy, to coordinate your treatment.
  • Payment. We may use your health information to bill and collect payment for services we provide to you. Because the Practice does not accept insurance, this generally means processing payments you make; if you request a statement of services (superbill) to submit to your own insurer, it will contain the health information needed for that purpose.
  • Health Care Operations. We may use your health information to run our practice and improve the quality of care, for example to review our services, train staff, maintain records, and work with business associates such as our electronic health record, billing, and documentation vendors.

For uses and disclosures for purposes other than treatment, payment, and health care operations, we are required to have your written authorization, unless the use or disclosure falls within an exception described below. Most uses and disclosures of psychotherapy notes (as that term is defined in the HIPAA Privacy Rule), uses and disclosures for marketing purposes, and disclosures that constitute a sale of protected health information require your authorization. Other uses and disclosures not described in this Notice will be made only with your written authorization. Authorizations can be revoked in writing at any time to stop future uses and disclosures, except to the extent that we have already taken action in reliance on your authorization.

Disclosures That Can Be Made Without an Authorization

  • Emergencies. Sufficient information may be shared to address an immediate emergency you are facing.
  • Family and Others Involved in Your Care. We may share information with a family member, friend, or other person you identify who is involved in your care, unless you object. If you are not present or able to agree or object, we may share information if we believe it is in your best interest. For minors, please see “Minors and Parents” below.
  • Required by Law. We may use or disclose health information when we are required to do so by federal, state, or local law.
  • Serious Threat to Health or Safety. If we believe you present an imminent danger to yourself or others, we may disclose health information to the extent necessary to prevent or lessen the threat, including to law enforcement or to a person who may be in danger.
  • Public Health Activities. We may disclose health information for public health purposes, such as reporting certain diseases, reporting adverse reactions to medications to the U.S. Food and Drug Administration, or preventing or controlling disease.
  • Child/Elder Abuse or Neglect. We may disclose health information to appropriate authorities when we suspect child abuse or neglect, or abuse or neglect of an older adult or dependent adult, as required or permitted by law.
  • Judicial and Administrative Proceedings. We may disclose health information in the course of a judicial or administrative proceeding in response to a valid court order or other lawful process.
  • Law Enforcement. We may disclose health information to law enforcement officials as permitted or required by law, including if a crime is committed on our premises or against our personnel.
  • Health Oversight Activities. We may disclose health information to a health oversight agency for activities authorized by law, such as audits, investigations, inspections, and licensure actions. These activities are necessary for the government to monitor the health care system and ensure compliance with the law. Only the minimum necessary information will be provided.
  • Coroners and Medical Examiners. We may disclose health information to a coroner or medical examiner as authorized by law.
  • Workers’ Compensation. We may disclose health information as authorized by and to the extent necessary to comply with workers’ compensation laws.
  • Specialized Government Functions. We may disclose health information for military, national security, and protective services purposes, and to correctional institutions, as authorized by law.
  • Business Associates. The Practice may disclose the minimum necessary health information to business associates that perform functions on our behalf or provide us with services. All of our business associates sign agreements to protect the privacy of your information, may not use or disclose it other than as specified in their contract, and must promptly notify us of any breach of protected health information.
  • Research. Under limited circumstances, we may use and disclose health information for research, such as when an institutional review board or privacy board has approved a waiver of authorization, or when the information does not identify you.
  • Appointment Reminders and Information About Our Services. We may contact you by phone, text, or email to schedule or remind you of appointments, and we may send you information about our own services that may be of interest to you. You may ask at any time to stop receiving these communications.

Additional Protections Under Pennsylvania Law

Pennsylvania law provides additional confidentiality protections for mental health treatment records and for certain other types of information, such as HIV-related information and drug and alcohol treatment records. When Pennsylvania law is more protective of your privacy than HIPAA, we follow Pennsylvania law. This means that some disclosures permitted under HIPAA may require your written consent.

Minors and Parents. Under Pennsylvania law, a minor age 14 or older may consent to their own outpatient mental health treatment, and a parent or legal guardian may also consent to treatment for a minor in that age group. Who may authorize the release of a minor’s records, and what information a parent or guardian may receive, depends on the minor’s age and on who consented to treatment. For minors under age 14, a parent or legal guardian generally acts on the minor’s behalf. We will explain how these rules apply to your family at the start of treatment, and you may ask us about them at any time.

Your Individual Rights

  • Right to Inspect and Copy. You have the right to look at or get copies of your health information, including in electronic form, with limited exceptions. Your request must be in writing. We will respond within 30 days, and a reasonable, cost-based fee may be charged for copies.
  • Right to Amend. You have the right to request that we amend your health information. Your request must be in writing, and it must explain why the information should be amended. We may deny your request under certain circumstances, and if we do, we will explain why in writing.
  • Right to an Accounting of Disclosures. You have the right to receive a list of instances in which we have disclosed your health information for purposes other than treatment, payment, or health care operations, or disclosures you authorized, during the six years before the date of your request. To request an accounting of disclosures, you must submit your request in writing to the Privacy Officer.
  • Right to Request Restrictions. You have the right to request a restriction or limitation on the health information we use or disclose about you. Requests should be made in writing to your provider or to the Privacy Officer. We are not required to agree to your request, except when you ask us not to disclose information to a health plan for payment or health care operations purposes and the information relates solely to a service for which you have paid in full. If we do agree, we will abide by the restriction unless the information is needed in an emergency or we are required by law to disclose it.
  • Right to Request Confidential Communications. You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you may ask that we contact you only by mail or at work. You must make this request in writing, and it must specify the alternative means or location you would like us to use. We will accommodate reasonable requests.
  • Right to a Paper Copy of This Notice. You have the right to a paper copy of this Notice at any time, even if you have agreed to receive it electronically.
  • Right to Be Notified of a Breach. You have the right to be notified if a breach of your unsecured protected health information occurs.
  • Right to File Complaints. If you believe your privacy rights have been violated, you may file a complaint with us by contacting the Privacy Officer using the information below. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue, S.W., Washington, D.C. 20201, by calling 1-877-696-6775, or online at www.hhs.gov/ocr/privacy/hipaa/complaints/. You will not be retaliated against for filing a complaint.

Contact Information

For questions about this Notice, to exercise any of the rights described above, or to file a complaint, please contact:

Privacy Officer: Jessee Valentine, DO

Valentine Psychiatry, PC

150 S. Warner Rd, Suite 130, King of Prussia, PA 19406

Phone: (610) 227-3888