NOTICE OF PRIVACY PRACTICES AND PRIVACY POLICY

Motivational Institute for Behavioral Health, LLC

Effective Date: Updated 10/05/2026

Your Information. Your Rights. Our Responsibilities.

This Notice describes how medical and behavioral health information about you may be used and disclosed, how you can obtain access to this information, and how Motivational Institute for Behavioral Health, LLC protects your privacy. Please review it carefully.

Motivational Institute for Behavioral Health, LLC is committed to protecting the privacy and confidentiality of our patients and complying with applicable federal and state privacy laws, including the Health Insurance Portability and Accountability Act of 1996 ("HIPAA").

INFORMATION WE COLLECT

We may collect personal and health information that you provide to us or that is created in connection with your care, including:

• Name, address, telephone number, email address, and other contact information

• Date of birth and demographic information

• Insurance and billing information

• Medical and behavioral health history

• Diagnoses, treatment plans, assessments, progress notes, and other clinical information

• Medication and health information relevant to treatment

• Appointment and scheduling information

• Information submitted through our website, patient portal, forms, telephone communications, email, or text messages

• Information obtained from other health care providers or persons involved in your care when permitted by law

Information related to behavioral health, psychotherapy, substance use treatment, and other sensitive health matters may receive additional protection under federal or state law.

YOUR RIGHTS

Obtain an Electronic or Paper Copy of Your Health Record

You may ask to inspect or obtain an electronic or paper copy of your medical or behavioral health record and other health information we maintain about you.

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You have immediate access to your records through the Electronic Health Records portal. If you have trouble accessing, you may contact our office for help. We will generally provide access within the period required by applicable law. If you request an electronic or paper copy from us, we may charge a reasonable, cost-based fee where permitted.

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Certain information may be subject to special rules, including psychotherapy notes and information protected by other federal or state laws.

Ask Us to Correct Your Health Record

If you believe health information we maintain about you 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 explain the reason in writing and describe your rights regarding the denial.

Request Confidential Communications

You may ask us to contact you in a particular way or at a particular location.

For example, you may request that we contact you only at a particular telephone number, email address, or mailing address.

We will accommodate reasonable requests.

Ask Us to Limit What We Use or Share

You may ask us not to use or disclose certain health information for treatment, payment, or health care operations. We are not required to agree to every request, except in circumstances where applicable law requires us to do so. If you pay for a health care service entirely out of pocket, you may ask us not to disclose information about that service to your health insurer for purposes of payment or health care operations. We will honor that request unless disclosure is otherwise required by law, by your contract with your insurance company, or our contract with your insurance company.

Obtain an Accounting of Certain Disclosures

You may ask for a list of certain disclosures we have made of your protected health information during the period allowed by law. The accounting does not include certain disclosures, such as many disclosures made for treatment, payment, or health care operations or disclosures you specifically authorized.

Obtain 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.

Choose Someone to Act for You

If you have given someone health care power of attorney or another person has legal authority to act on your behalf, that person may exercise your rights and make choices regarding your health information as permitted by law.

We may verify that person's authority before taking action.

File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with Motivational Institute for Behavioral Health, LLC.

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.

We will not retaliate against you for filing a complaint.

YOUR CHOICES

For certain health information, you may tell us your preferences regarding what we share.

Where permitted by law, you may tell us whether we may:

• Share relevant information with family members, friends, caregivers, or others involved in your care

• Share information in a disaster-relief situation

• Communicate with another person on your behalf

• Use or disclose information for certain marketing or fundraising activities

If you are unable to communicate your preference, we may disclose information when we determine that doing so is in your best interest and is permitted by law.

We generally will not sell your protected health information.

Uses or disclosures of your information for purposes requiring an authorization under HIPAA will not occur without your written authorization.

You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.

HOW WE MAY USE AND DISCLOSE YOUR INFORMATION

Treatment

We may use and disclose your health information to provide, coordinate, or manage your treatment. For example, we may share relevant health information with another therapist, psychologist, psychiatrist, physician, dietitian, hospital, pharmacy, or other health care professional involved in your care when permitted by law, or permitted by you by written or verbal authorization/request.

Payment

We may use and disclose your health information to bill and obtain payment from health plans, insurers, or other responsible parties. For example, we may provide information necessary to determine eligibility, obtain authorization, submit claims, or address payment issues; this may include credit or collection agencies for unpaid balances.

Health Care Operations

We may use and disclose your information for activities necessary to operate our practice and improve the quality of care.

Examples include:

• Quality assessment and improvement

• Clinical supervision

• Staff training

• Credentialing

• Compliance activities

• Auditing

• Business planning

• Patient safety activities

• Administrative functions

We follow the HIPAA "minimum necessary" standard when it applies and make reasonable efforts to limit the information used or disclosed to what is reasonably necessary for the intended purpose.

Business Associates

We may share protected health information with companies or individuals that perform services for us, such as electronic health record providers, billing companies, information technology providers, document storage companies, laboratories, or other vendors.

When required by HIPAA, these entities enter into agreements requiring them to appropriately safeguard protected health information.

Required by Law

We may use or disclose your information when required by federal, state, or local law.

Public Health and Safety

Where permitted or required by law, we may disclose information for certain public health and safety purposes, including:

• Reporting certain diseases or conditions

• Preventing or reducing a serious and imminent threat to health or safety

• Reporting suspected abuse, neglect, exploitation, or domestic violence when required or permitted by law

Health Oversight

We may disclose information to government agencies responsible for health oversight activities permitted by law, such as audits, investigations, inspections, and licensure activities.

Judicial and Administrative Proceedings

We may disclose health information in response to certain court orders, subpoenas, administrative proceedings, or other lawful processes, subject to applicable privacy protections.

Law Enforcement

We may disclose information to law enforcement when specifically permitted or required by law.

Workers' Compensation and Similar Programs

We may disclose information as authorized by and necessary to comply with workers' compensation laws and similar programs.

Coroners, Medical Examiners, and Funeral Directors

We may disclose health information as permitted by law to coroners, medical examiners, or funeral directors.

BEHAVIORAL HEALTH AND PSYCHOTHERAPY INFORMATION

Because our practice provides behavioral health services, some information we maintain may receive additional protection.

Psychotherapy notes, as defined under HIPAA, generally receive greater protection than other treatment records and ordinarily will not be used or disclosed without your written authorization except in limited circumstances permitted by law.

Florida law and other applicable laws may also provide additional protections for mental health records. Where applicable law provides greater privacy protection than HIPAA, we will comply with the more protective requirement.

SUBSTANCE USE DISORDER INFORMATION

Certain records relating to substance use disorder diagnosis, treatment, or referral for treatment may be protected by additional federal confidentiality requirements, including 42 CFR Part 2, when those requirements apply.

When Part 2 applies, such information generally receives additional protections regarding its use and disclosure. Information protected by Part 2 will be handled in accordance with applicable federal requirements.

A separate or combined Part 2 notice may be provided when required by law.

ELECTRONIC COMMUNICATIONS

We may communicate with you through telephone, voicemail, email, patient portals, telehealth platforms, and text messaging when appropriate.

Electronic communications can involve privacy risks. Although we use reasonable administrative, technical, and physical safeguards, no electronic method of communication can be guaranteed to be completely secure.

We encourage patients not to send highly sensitive clinical information through ordinary text messages or unsecured email.

Electronic communications should not be used for emergencies. If you are experiencing a medical or psychiatric emergency, call 911, go to the nearest emergency department, or use an appropriate crisis service.

SMS / TEXT MESSAGING PRIVACY

Motivational Institute for Behavioral Health, LLC may use text messaging for communications such as:

• Appointment scheduling

• Appointment confirmations and reminders

• Rescheduling or cancellation communications

• Intake and administrative communications

• Responses to patient or prospective-patient inquiries

• Limited care-coordination communications

• Notifications regarding paperwork or other administrative requirements

Message frequency may vary. Message and data rates may apply.

You may opt out of non-required SMS communications at any time by replying STOP. For assistance, reply HELP or contact our office.

Providing consent to receive text messages is not a condition of receiving health care services from Motivational Institute for Behavioral Health, LLC.

SMS consent is not shared with third parties or affiliates for marketing or promotional purposes. SMS consent is not shared with third parties.

Mobile telephone numbers and SMS opt-in information will not be sold or provided to third parties for their independent marketing purposes.

We may use technology vendors that assist us in transmitting communications on our behalf, subject to applicable privacy, security, and contractual requirements.

WEBSITE PRIVACY

When you use our website, we may collect information you voluntarily provide through contact forms, appointment requests, or other communications.

We may also collect limited technical information ordinarily associated with website use, such as browser type, device information, IP address, or general website activity.

We may use website information to:

• Respond to inquiries

• Facilitate appointment requests

• Operate and improve our website

• Maintain security

• Communicate with users who request information

• Carry out legitimate administrative and business functions

We do not sell patient protected health information.

Information submitted through our website that becomes part of your health care record will be handled in accordance with applicable privacy laws and this Notice.

OUR RESPONSIBILITIES

Motivational Institute for Behavioral Health, LLC is required by law to:

• Maintain the privacy and security of protected health information

• Follow the duties and privacy practices described in the Notice currently in effect

• Provide you with this Notice

• Notify affected individuals when required if a breach occurs that may have compromised the privacy or security of protected health information

• Limit uses and disclosures of protected health information as required by applicable law

We will not use or disclose your information for purposes not described in this Notice unless you authorize us to do so in writing or the use or disclosure is otherwise permitted or required by law.

SECURITY SAFEGUARDS

We use reasonable administrative, technical, and physical safeguards designed to protect protected health information.

These safeguards may include:

• Access controls

• Password protections

• Secure electronic systems

• Workforce confidentiality requirements

• Staff privacy and security training

• Procedures governing access to patient records

• Secure storage and disposal practices

• Vendor and business-associate agreements when required

• Policies addressing privacy or security incidents

Access to protected health information is limited to workforce members and other authorized persons who need the information to perform their responsibilities.

CHANGES TO THIS NOTICE

We may change the terms of this Notice and Privacy Policy.

Changes may apply to all information we maintain, including information created or received before the revised Notice takes effect.

The current Notice will be available upon request and will be posted on our website.

PRIVACY QUESTIONS OR COMPLAINTS

If you have questions regarding this Notice, wish to exercise your privacy rights, or believe your privacy rights have been violated, please contact:

Privacy Officer
Motivational Institute for Behavioral Health, LLC
1421 SE 4th Ave., FL 1

Fort Lauderdale, FL 33316
954-616-5088
Coordinator@mifbh.com

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
Telephone: 1-877-696-6775

You will not be retaliated against for filing a privacy complaint.