Effective Date: February 19, 2026
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 Commitment to Your Privacy
Elessar Psychiatry PLLC is required by law to:
- Maintain the privacy of your protected health information (PHI)
- Provide you with this Notice
- Follow the terms currently in effect
- Notify you following a breach of unsecured PHI when required
How We May Use and Disclose Your PHI
For Treatment
We may use and disclose your PHI to provide, coordinate, or manage your mental health care.
For Payment
We may use and disclose PHI to obtain payment for services, including billing insurance plans.
For Health Care Operations
We may use PHI for business operations such as:
- Quality assessment
- Care coordination
- Credentialing
- Compliance activities
Other Permitted or Required Uses
We may disclose PHI when required or permitted by law, including:
- Public health activities
- Health oversight
- Legal proceedings
- Law enforcement requests
- Serious threats to health or safety (duty to warn)
- Abuse or neglect reporting
Uses Requiring Your Authorization
We will obtain your written authorization for uses not otherwise permitted, including most uses of psychotherapy notes where applicable.
You may revoke authorization in writing at any time, except where we have already relied on it.
Your Rights Regarding Your PHI
You have the right to:
- Inspect and obtain a copy of your records
- Request amendments to your records
- Request restrictions on certain disclosures
- Request confidential communications
- Receive an accounting of disclosures
- Obtain a paper copy of this Notice
Requests must be submitted in writing.
Special Protections for Mental Health Information
Certain mental health records may receive additional protections under federal and state law. We comply with applicable Utah, Colorado, and federal requirements regarding:
- Psychotherapy notes
- Minor consent laws
- Substance use information where applicable
Complaints
If you believe your privacy rights have been violated, you may file a complaint with:
Elessar Psychiatry PLLC
Email: katy@elessarpsychiatry.care
or with the U.S. Department of Health and Human Services Office for Civil Rights.
You will not be retaliated against for filing a complaint.
Changes to This Notice
We reserve the right to change this Notice and make the revised version effective for all PHI we maintain. Updated versions will be posted on our website.
Contact Information
Elessar Psychiatry PLLC
169 W 2710 S Circle, Suite 202A
St. George, UT 84790
Phone: 720-664-9877
Email: katy@elessarpsychiatry.care