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.

OUR RESPONSIBILITIES
This practice protects your health information as required by law and by this Notice. We are required by law to maintain the privacy and security of your protected health information (PHI), to provide you with this Notice, and to follow the terms of the Notice currently in effect. We will promptly notify you if a breach occurs that compromises the privacy or security of your unsecured PHI. We will use and disclose your PHI only as described in this Notice or as otherwise permitted or required by law. We will not use your PHI for marketing or sell your PHI without your written authorization. When we work with trusted vendors (business associates), we require them by contract to safeguard your information. We will limit uses, disclosures, and access to the minimum necessary to accomplish the intended purpose, when applicable. If we change our privacy practices, we will update this Notice and make the revised version available in our office and upon request.

USES AND DISCLOSURES WITHOUT YOUR AUTHORIZATION
Your protected health information (PHI) may be used and disclosed for treatment, payment, and health care operations (for example, coordinating care, billing, and quality improvement); assistants acting under my direction may access information as needed to carry out these activities; for public health and safety purposes; for health oversight, audits, and compliance; in judicial and administrative proceedings, for law enforcement, and as otherwise required by law; for coroners, medical examiners, funeral directors, organ donation, and workers’ compensation; and, when permitted, for a limited facility directory and to persons involved in your care or payment. Where other laws are more restrictive than HIPAA, the more stringent law applies.

OTHER USES AND DISCLOSURES
Other uses and disclosures require your written authorization, which you may revoke in writing except where already relied upon.

YOUR RIGHTS
You have the right to receive or inspect a copy of your health information; to request corrections to your records; to receive an accounting of certain disclosures; to request limits on uses and disclosures (including a right to restrict disclosure to a health plan for items or services paid in full out of pocket, when applicable); to request confidential communications by a specific method or at a specific location; and to obtain a paper or electronic copy of this Notice. Complaints about privacy rights may be submitted to the contact below or to the U.S. Department of Health and Human Services, Office for Civil Rights, without retaliation.

SUBSTANCE USE DISORDER RECORDS (42 CFR PART 2)
If SUD records protected by Part 2 are created or maintained by this practice, stricter limits apply. In general, SUD records may not be used or disclosed for treatment, payment, or health care operations without your written consent, even where HIPAA would otherwise permit such disclosures. Part 2 treatment records, or testimony relaying their content, may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless you provide written consent, or a court orders disclosure after notice and an opportunity to be heard; any court order authorizing use or disclosure must be accompanied by a subpoena or other legal requirement compelling disclosure before the record is used or disclosed. Where other laws are more protective, those more stringent requirements apply.

FUNDRAISING
This practice does not use or disclose your protected health information for fundraising communications.

NONDISCRIMINATION AND ACCESSIBILITY
Federal nondiscrimination laws are followed, including reasonable steps to provide meaningful access such as language assistance and accessible formats for individuals with disabilities, as required.

PRIVACY CONTACT
Maki Kurata, Lic. Ac.
3330 West 26th Street, Unit 5
Erie, PA 16506
814-602-8309
admin@makikurata.com

Effective Date: January 1, 2026