Privacy Notice for The Soulful Psychologist

Effective Date: September 1, 2025

Notice of Privacy Practices

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.

The Soulful Psychologist (Dr. Suzanne Meunier) is committed to protecting your privacy. I am required by federal law to maintain the privacy of Protected Health Information ("PHI"), which is information that identifies or could be used to identify you. I am required to provide you with this Notice of Privacy Practices, which explains my legal duties and privacy practices and your rights regarding PHI that I collect and maintain

Your Rights

Your rights regarding PHI are explained below. To exercise these rights, please submit a written request to me at the contact information provided below.

Right to Inspect and Copy PHI

• You can ask for an electronic or paper copy of your PHI. I may charge you a reasonable fee for copying and mailing costs. • I may deny your request if I believe the disclosure will endanger your life or another person's life. You may have a right to have this decision reviewed.

Right to Amend PHI

• You can ask to correct PHI you believe is incorrect or incomplete. I may require you to make your request in writing and provide a reason for the request. • I may deny your request and will send a written explanation for the denial and allow you to submit a written statement of disagreement.

Right to Request Confidential Communications

• You can ask me to contact you in a specific way (for example, home or office phone, email, or mail to a different address). I will accommodate all reasonable requests. • This is particularly important for telehealth services where you may prefer specific communication methods.

Right to Limit What Is Used or Shared

• You can ask me not to use or share PHI for treatment, payment, or business operations. I am not required to agree if it would affect your care. • Since I do not accept insurance, if you pay for services out-of-pocket in full, your PHI will not be shared with health insurers unless you specifically request it. • You can ask me not to share your PHI with family members or friends by stating the specific restriction requested and to whom you want the restriction to apply.

Right to an Accounting of Disclosures

• You can ask for a list of times your health information has been shared outside of routine treatment, payment, and operations. You can receive one accounting every 12 months at no charge.

Right to a Copy of This Notice

• You can ask for a paper copy of this Notice, even if you agreed to receive it electronically.

Right to Choose Someone to Act for You

• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

Right to File a Complaint

• You can file a complaint if you feel your rights are violated by contacting:

Dr. Suzanne Meunier
The Soulful Psychologist
P.O. Box 614
Windham, ME 04062
207-200-7481
Email: [contact information from website]

• You can 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, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. • I will not retaliate against you for filing a complaint.

How I Use and Share Your Health Information

For Treatment

• I can use and share PHI with other healthcare professionals who are treating you when clinically necessary. • Example: Coordinating care with your primary care physician or psychiatrist with your consent. • Note: As a telehealth-only practice, most coordination occurs through secure electronic communication.

For Payment

• Since I operate as a fee-for-service practice and do not participate with insurance plans, PHI sharing for payment is minimal. • I may use PHI to prepare invoices and statements for you. • If you choose to submit claims to your insurance company for potential out-of-network reimbursement, I can provide you with the necessary documentation.

For Healthcare Operations

• I can use and share PHI to improve your care and contact you when appropriate. • Examples: Appointment reminders, treatment plan reviews, quality assurance activities. • Telehealth-specific: Technical support for secure video platform issues, if necessary.

Special Considerations for Telehealth Services

• All telehealth sessions are conducted through HIPAA-compliant, encrypted video platforms. • Technical support personnel may have limited access to connection logs but not session content. • You have the right to know which platforms I use and their privacy practices.

Uses and Disclosures That May Be Made Without Your Authorization

I may use or disclose PHI without your authorization in the following circumstances:

Public Health and Safety

• To prevent the spread of disease or assist with public health investigations • To report adverse reactions to medications • To report suspected abuse, neglect, or domestic violence as required by law

Legal Requirements

• When required by federal, state, or local law • To respond to court orders, subpoenas, or legal discovery requests • For law enforcement purposes when legally required

Threats to Health or Safety

• To prevent a serious and imminent threat to your health and safety or that of others • Important for my practice: This includes situations involving risk of suicide, homicide, or inability to care for yourself

Government Functions

• For specialized government functions including military, national security, intelligence activities, or protective services • For workers' compensation claims if applicable • For health oversight activities such as audits or investigations

Other Legally Required Disclosures

• To coroners, medical examiners, and funeral directors when necessary • For organ donation purposes if you are an organ donor • For approved research projects (rare and with strict safeguards)

Uses and Disclosures Requiring Your Written Authorization

I must obtain your written authorization before using or disclosing PHI for:

• Marketing purposes (though educational materials about treatment options don't require authorization) • Sale of PHI • Most uses of psychotherapy notes (detailed notes from therapy sessions have special protections) • Any other purpose not described in this Notice

Important: You may revoke your authorization at any time by contacting me in writing. However, I cannot take back disclosures already made with your authorization.

Special Protections for Sensitive Information

Psychotherapy Notes

• Detailed process notes from therapy sessions have extra legal protections • These are kept separate from your regular medical record • I need your specific written authorization to share these in most situations

Psychedelic Integration Work

• Information about your psychedelic experiences and integration work is treated with the highest level of confidentiality • This information is only shared if legally required or with your specific written consent

Spiritual and Religious Information

• Personal spiritual beliefs, practices, and experiences shared in therapy are protected health information • I will not disclose this information without your authorization except as required by law

My Responsibilities

• Privacy Protection: I am required by law to maintain the privacy and security of your PHI and to follow the terms of this Notice. • Breach Notification: I will notify you if your PHI is compromised in a data breach. • Updates to This Notice: I reserve the right to change this Notice. Any changes will apply to all PHI I maintain. You can obtain a current copy by requesting one or viewing it on my website at thesoulfulpsychologist.com. • More Stringent Laws: Where more stringent state or federal laws govern PHI, I will follow those stricter requirements.

Telehealth-Specific Privacy Information

Platform Security

• All video sessions use encrypted, HIPAA-compliant platforms • Session recordings are not made unless specifically requested and authorized by you • I will inform you of the specific platform being used and its privacy practices

Technology Requirements

• You are responsible for ensuring your internet connection and device are secure • I recommend using a private, secure internet connection rather than public Wi-Fi • You should be in a private location where others cannot overhear our session

State Licensing and PSYPACT

• I am authorized to provide telehealth services across PSYPACT participating states • Your location during sessions must be in a state where I am licensed to practice • Different states may have varying privacy requirements, which I will follow

Contact Information

Suzanne Meunier, Ph.D.
The Soulful Psychologist
P.O. Box 614
Windham, ME 04062
Phone: 207-200-7481
Website: thesoulfulpsychologist.com

For questions about this Notice or to exercise your rights regarding your PHI, please contact me using the information above.

This Notice is effective as of September 1, 2025.

Note: This Notice may be updated from time to time. The most current version will always be available on my website at thesoulfulpsychologist.com. You have the right to receive a paper copy of this Notice upon request