Notice of Privacy Practices

NOTICE OF PRIVACY PRACTICES
Effective Date: March 2026

TW Therapy Group
411 Clarendon Ct, Ste. 102
Savoy, IL 61874
217-607-1839

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

I. TW THERAPY GROUP PLEDGE REGARDING HEALTH INFORMATION

TW Therapy Group (hereinafter “we”) understands that health information about you and your health care is personal. We are committed to protecting your health information. We create a record of the care and services you receive from us, and we need this record to provide you with quality care and to comply with certain legal requirements.

This notice applies to all of the records of your care generated by this mental health care practice. This notice will tell you about the ways in which we may use and disclose health information about you. We also describe your rights regarding the health information we keep about you and our obligations concerning the use and disclosure of your health information.

We are required by law to:
• Make sure that protected health information (“PHI”) that identifies you is kept private
• Give you this notice of our legal duties and privacy practices
• Follow the terms of the notice that is currently in effect

We reserve the right to change the terms of this Notice. Any changes will apply to all information we have about you. The updated Notice will be available upon request, in our office, and on our website.

II. HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU

The following categories describe different ways that we use and disclose health information. Not every use or disclosure will be listed, but all permitted uses fall within one of these categories.

For Treatment and Health Care Operations
We may use or disclose your PHI to provide, coordinate, or manage your care. For example, a clinician may consult with another licensed provider to assist in diagnosis or treatment. These disclosures may occur without your written authorization.

For Payment
We may use and disclose your information to obtain payment for services. For example, we may submit information to your insurance company. Your insurance provider may require a diagnosis or review of records for payment purposes. By submitting a claim, you consent to the release of necessary information to your insurance carrier.

Lawsuits and Disputes
If you are involved in a legal proceeding, we may disclose health information in response to a court or administrative order. We may also disclose information in response to a subpoena or lawful request, provided appropriate safeguards are in place.

III. USES AND DISCLOSURES THAT REQUIRE YOUR WRITTEN AUTHORIZATION

Psychotherapy Notes
We maintain psychotherapy notes as defined by law. Any use or disclosure of these notes requires your written authorization, except in the following situations:
• For use in your treatment
• For training or supervision of clinicians
• For legal defense if you initiate proceedings
• For compliance investigations by the Department of Health and Human Services
• When required by law
• To prevent a serious threat to health or safety

Marketing and Sale of PHI
We do not sell or use your PHI for marketing purposes without your written authorization.

IV. USES AND DISCLOSURES THAT DO NOT REQUIRE AUTHORIZATION

We may use or disclose your PHI without your authorization in the following situations, subject to legal limitations:

• When required by federal or state law
• For public health activities (e.g., reporting abuse or preventing serious threats)
• For health oversight activities such as audits or investigations
• For judicial or administrative proceedings
• For law enforcement purposes
• To coroners or medical examiners
• For approved research purposes
• For specialized government functions (e.g., military or national security)
• For workers’ compensation compliance
• For appointment reminders and information about treatment options or services

V. USES AND DISCLOSURES WHERE YOU HAVE THE OPPORTUNITY TO OBJECT

We may share your PHI with family members, friends, or others involved in your care or payment for care, unless you object. In emergency situations, this may occur without prior consent.

VI. YOUR RIGHTS REGARDING YOUR PHI

You have the following rights regarding your protected health information:

• The right to request limits on certain uses and disclosures (we may deny requests if they affect your care)
• The right to restrict disclosures to health plans if you pay out-of-pocket in full
• The right to request confidential communication methods (e.g., alternate phone or address)
• The right to access and obtain a copy of your records (excluding psychotherapy notes)
• The right to request an accounting of disclosures
• The right to request corrections to your records
• The right to receive a paper or electronic copy of this Notice

VII. QUESTIONS OR COMPLAINTS

If you have questions about this Notice or believe your privacy rights have been violated, you may contact:

TW Therapy Group
217-607-1839

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. Filing a complaint will not affect your care.

ACKNOWLEDGMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have certain rights regarding the use and disclosure of your protected health information. By signing below, you acknowledge that you have received a copy of this Notice of Privacy Practices.