Mental Therapy and Counseling near Tampa, FL
This notice describes how medical and behavioral health related information about you may be used and disclosed and how you can get access to this information. Please review this notice carefully.


It is important that you understand confidentiality, your right to privacy and the rights of other clients. Also, you must understand the legal limits or exceptions to these rights. Your records will not be released without a signed Release of Information except under circumstances that fall into these categories: a valid medical emergency, receipt of a Court Order, receipt of a request which is governed by state statutes, internal communications, data with no-patient identifying information, research, audit and evaluation, crime at program/against program personnel, child abuse and business associate agreements. For example, if we learn or discover you have a communicable disease like hepatitis or tuberculosis, we are required to contact the County Public Health Department.


This describes how Medical and Drug and Alcohol related information about you may be used and disclosed and how you can get access to this information. Please review carefully.

Information regarding your health care, including payment for health care, is protected by two federal laws; the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), 42 U.S.C. § 1320d et seq., 45 C.F.R. Parts 160 & 164, and the Confidentiality Law, 42 U.S.C. § 290dd-2, 42 C.F.R. Part 2. Under these laws, New Life 360, Inc. may not disclose any information identifying you as an alcohol or drug abuser or disclose any other protected information except as permitted by federal law.

New Life 360, Inc. must obtain your written consent before it can disclose information about you for payment purposes.  For example, New Life 360, Inc.  must   obtain   your   written   consent before it can disclose information to your health insurer in order to be paid for services.  Generally, you must also sign a written consent before New Life 360, Inc.  can share information for treatment purposes or for health care operations.  However, federal law permits New Life 360, Inc. to disclose information without your written permission:

  1. Pursuant to an agreement with a qualified service organization / business associate;
  2. For research, audit or evaluations;
  3. To report a crime committed on New Life 360, Inc.’s premises or against New Life 360, Inc. personnel;
  4. To medical personnel in a medical emergency;
  5. To appropriate authorities to report suspected child abuse or neglect;
  6. As allowed by a court order.
    For example, New Life 360, Inc. can disclose information without your consent to obtain legal or financial services, or to another medical facility to provide health care to you, if there is a qualified service organization / business associate agreement in place.

Before New Life 360, Inc. can use or disclose any information about your health in a manner that is not described above, it must first obtain your specific written consent allowing it to make    the disclosure. Any such written consent may be revoked by you, in writing.

Your Rights Under the Health Insurance Portability Accountability Act (HIPAA) you have the right to request restrictions on certain uses and disclosures of your health information.  New Life 360, Inc. is not required to agree to any restrictions you request, but if  it does agree then it is bound by that agreement and may not use or  disclose  any  information which you have restricted except as necessary in a medical emergency.

You have the right to request that we communicate with you by alternative means or at an alternative location. New Life 360, Inc. will accommodate such requests that are reasonable and will not request an explanation from you.  Under HIPAA you also have the right to inspect and copy your own health information   maintained   by   New   Life   360,  Inc.,   except   to   the   extent   that    the  information   contains   psychotherapy notes or information compiled for use in a civil, criminal   or administrative proceeding or other limited circumstances as defined in 42 C.F.R. Revised: 04/15/05; Revised 7/8/05

Under HIPAA you also have the right, with some exceptions, to amend health care information maintained in New Life 360, Inc.’s records and to request and receive an accounting of disclosures of your health-related information made by New Life 360, Inc.  during the six years prior to your request. You also have the right to receive a paper copy of this notice.

New Life 360, Inc.’s Duties: New Life 360, Inc.  is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices with respect to your health information.  New Life 360, Inc. is required by law to abide by the terms of this notice. New Life 360, Inc. reserves the right to change the terms of this notice and to make new notice provisions effective for all protected health information it maintains.  Upon request, New Life 360, Inc. will mail you our most recent notice.

Complaints and Reporting Violations: You may complain to New Life 360, Inc.  and the Secretary of the United State Department of Health and Human Services if you believe that your privacy rights have been violated under HIPAA.  Your complaint may be mailed to New Life 360’s Privacy Officer (listed below). You will not be retaliated against for filing such a complaint.


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What rights you have over your data

If you have an account on this site, or have left comments, you can request to receive an exported file of the personal data we hold about you, including any data you have provided to us. You can also request that we erase any personal data we hold about you. This does not include any data we are obliged to keep for administrative, legal, or security purposes.

For further information contact: Sherry Bradley CEO/Founder, LCSW, MCAP 813-548-1166