Journey Inward Therapy

1221 Bower Parkway, Columbia, SC 29212

Phone: 803-233-6956 | Website: journeyinwardsc.com

Notice of Privacy Practices Statement

Journey Inward Therapy follows HIPAA regulations to protect the privacy of your Protected Health Information (PHI). Your health information may be used and disclosed for:

• Treatment purposes

• Payment processing

• Healthcare operations

• Cases required by law

Our complete Notice of Privacy Practices has been made available to you and provides detailed information about how we handle your protected health information.

Summary of Patient Rights

You have the right to:

• Access and request copies of your health records

• Request corrections or amendments to your health information

• Request restrictions on certain uses and disclosures of your information

• Request confidential communications about your health information

• Receive an accounting of how your health information has been disclosed

• File a complaint with the U.S. Department of Health & Human Services, Office for Civil Rights if you believe your privacy rights have been violated

Acknowledgment of Receipt

I acknowledge that I have been provided a copy of Journey Inward Therapy's Notice of Privacy Practices and have had the opportunity to ask questions about it.