Legal · HIPAA

Notice of Privacy Practices

Effective 2026-10-23 · MoodRx LLC

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 Legal Duty

MoodRx LLC ("MoodRx," "we," "us," or "our") is required by the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") and its implementing regulations to maintain the privacy of your protected health information ("PHI"), to provide you with this Notice of our legal duties and privacy practices with respect to PHI, to notify you following a breach of unsecured PHI, and to abide by the terms of the Notice currently in effect. We reserve the right to change the terms of this Notice and to make the new Notice provisions effective for all PHI that we maintain. A current copy of this Notice is always available at moodrx.com/hipaa.

How We May Use and Disclose Your PHI

Treatment

We may use and disclose your PHI to provide, coordinate, or manage your mental health care and any related services. This includes the sharing of PHI among the licensed clinicians, supervisors, and administrative staff of MoodRx who are involved in your care, and with other healthcare providers (such as a prescribing clinician or primary-care physician) when necessary to coordinate your treatment.

Payment

We may use and disclose your PHI to obtain payment for the services we provide. This includes sharing PHI with your health insurance plan, clearinghouses, and billing partners for the purposes of eligibility verification, claim submission, prior authorization, utilization review, and collection activities.

Health Care Operations

We may use and disclose your PHI for operations necessary to run our practice, including quality assessment, clinician credentialing and peer review, training, auditing, compliance, business planning, and general administrative activities.

As Required by Law

We may use or disclose your PHI when required to do so by federal, state, or local law.

Public Health and Safety

We may disclose PHI when necessary to prevent or lessen a serious and imminent threat to your health or safety or the health or safety of others, consistent with applicable law and standards of ethical conduct, including to law enforcement or persons able to prevent or lessen the threat.

Mandatory Reporting

Florida law requires us to report suspected abuse, neglect, or exploitation of a child, elderly person, or vulnerable adult. Clinicians are required to break confidentiality to make these reports.

Judicial and Administrative Proceedings

We may disclose PHI in response to a court order, subpoena, discovery request, or other lawful process, subject to the requirements of HIPAA and applicable law.

Business Associates

We may share PHI with third-party "business associates" that perform services on our behalf, such as our electronic health record vendor, secure video platform, claims clearinghouse, and secure email infrastructure. Each such business associate is contractually required under a HIPAA-compliant Business Associate Agreement to safeguard your PHI and to use it only for authorized purposes.

Appointment Reminders and Health-Related Information

We may contact you to remind you of appointments and to tell you about or recommend treatment alternatives or other health-related benefits and services. You may opt out of these communications at any time by calling us at 863-320-2545.

Uses and Disclosures Requiring Your Written Authorization

Other uses and disclosures of PHI not described in this Notice will be made only with your written authorization. In particular, we will obtain your written authorization before:

• Using or disclosing your PHI for marketing purposes;
• Selling your PHI;
• Using or disclosing most psychotherapy notes (notes recorded by a mental health professional documenting or analyzing the contents of conversation during a counseling session) for any purpose other than by the clinician who created them, for supervision or training, or for defense of a legal action by you;

You may revoke an authorization at any time in writing, except to the extent that we have already acted in reliance on it.

Your Rights with Respect to Your PHI

Right to Request Restrictions

You have the right to request a restriction on certain uses and disclosures of your PHI for treatment, payment, or health care operations. We are not required to agree to a requested restriction except in the limited circumstance where the disclosure is to a health plan for payment or operations purposes and the PHI pertains solely to a healthcare item or service for which you have paid us in full out of pocket.

Right to Receive Confidential Communications

You have the right to request that we communicate with you about medical matters in a specific way or at a specific location. For example, you may ask that we contact you only at a certain phone number. We will accommodate reasonable requests.

Right to Access, Inspect, and Copy

You have the right to inspect and obtain a copy of your PHI contained in a designated record set for as long as we maintain the PHI, with limited exceptions. You may request a copy in paper or electronic form. We may charge a reasonable, cost-based fee for copies.

Right to Amend

You have the right to request that we amend your PHI if you believe it is incorrect or incomplete. We may deny your request under certain circumstances. If we deny, we will provide a written explanation and you may submit a written statement of disagreement to be included in your record.

Right to an Accounting of Disclosures

You have the right to receive a list ("accounting") of certain disclosures of your PHI made by us, generally those made for purposes other than treatment, payment, or healthcare operations, in the six years prior to the date of request. The first accounting in a twelve-month period is free; additional accountings may be subject to a reasonable fee.

Right to Notification of Breach

You have the right to be notified in the event of a breach of your unsecured PHI.

Right to a Paper Copy of This Notice

You have the right to a paper copy of this Notice at any time, even if you have previously agreed to receive it electronically. You may print this page from your browser at any time.

How to Exercise Your Rights or File a Complaint

To exercise any of the rights described above, please call MoodRx LLC at 863-320-2545. Written requests may be mailed to: MoodRx LLC, 7901 4th St N, Ste 300, St Petersburg, FL 33702, Attention: Privacy Officer.

If you believe your privacy rights have been violated, you may file a complaint with us by calling the number above. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, by sending a letter to 200 Independence Avenue S.W., Washington, D.C. 20201, by calling 1-877-696-6775, or by visiting www.hhs.gov/ocr/privacy/hipaa/complaints/ .

We will not retaliate against you for filing a complaint.

Changes to This Notice

We reserve the right to change the terms of this Notice at any time. Changes apply to all PHI we maintain. The revised Notice will be available at moodrx.com/hipaa and will indicate its new effective date.

To speak with our Privacy Officer, call 863-320-2545.