CULTIVATING CHANGES, LLC
(Last Updated: 3/1/19)
Stephanie R Dietrich, LCSW DBA Cultivating Changes, LLC is dedicated to guarding your privacy. For privacy protection, we have summarized the privacy information and practices below and are making this information available to you via this website. Please read carefully:
1. INFORMATION COLLECTION AND USE
It is not necessary that you give us any personal information in order to use our Site. If you elect to buy an e-product, e-book, e-materials via this site, your credit card information will be necessary for payment. Additionally, this Site may utilize forms in which you provide us with your contact information (including your name, address, telephone number, and email address) so you are able to request information or support. We receive and store any information you enter on our Site, or give us in any other way, including through email, telephone, or other communications within our practice.
We will not sell, share, trade or otherwise use any information you provide unless you specifically give us, in writing, consent for such use. This information is collected in an effort to improve our service as well as to help us determine your specific needs in order to serve you better individually, as well as collectively.
We will not sell, share, trade or otherwise use any medical information under any circumstances. If you require medical information, you must request it from us directly via a Medical Release form.
We may also gather non-personally identifiable information about you, such as your use of our web sites, communication preferences, aggregated data relative to your Services, and responses to promotional offers and surveys. We may use or release aggregate information only where no individual is identified for a number of purposes, including the following: (a) Collecting aggregate measurements of usage for improving the web site; (b) Developing, maintaining and administering the web site; (c) Responding to comments and other messages that you submit to us through the web site; and (d) Responding to blog comments.
Please note, in order to better protect your information, please do not include any credit card information in your electronic communication unless it is particularly required by us as part of Services or transaction fulfillment process sites, or our customer contact process.
This Site and our Services may contain links to other websites. Unfortunately, we are not held accountable for the privacy practices or the content of such sites.
Security procedures are in place on this Site to protect against the loss, misuse or alteration of the information under our control. If you enter any sensitive information on our site (such as a credit card number) on order forms or intake documents, we encrypt the transmission of that information.
At times, we may also provide information concerning you to third parties in an effort to provide various services on our behalf, such as providers who process credit card payments. Your information will only be shared for that which is necessary for the third party to provide the requested service. These companies are prohibited from keeping, sharing, buying, selling, storing or using your personally identifiable information for any secondary purposes.
We follow commonly accepted standards in an effort to protect the personal information given to us, both during transmission and once we receive it. However, no method of transmission over the Internet, or method of electronic storage, is one hundred percent (100%) protected. As a result, we cannot promise its complete security.
3. GOOGLE ANALYTICS AND COOKIES
We may use a tool called “Google Analytics” to gather information about the utilization of this Site, for example: how often the Site is visited by users, what pages are visited, and what other sites users visited prior to coming to this Site. Google Analytics gathers only the IP address assigned to you on the date you visit this Site, rather than your name or other identifying information.
In order to classify you as a unique user the each time you visit this Site, Google Analytics will plant a permanent cookie on your web browser. This cookie is not usable by anyone but Google, Inc. The information produced by the cookie will be transmitted to and stored by Google on servers in the United States.
The information gathered by Google Analytics is used only to improve services on this Site. We do not combine the information collected through the use of Google Analytics with personally identifiable information.
4. COLLECTION AND USE OF PERSONAL INFORMATION OF CHILDREN UNDER AGE 13
We are dedicated to protecting the online privacy of minor children. In agreement with the Children’s Online Privacy Protection Act (”COPPA”), without first obtaining parental consent, we will not knowingly collect any personally identifiable information from children below the age of thirteen (13). Prior to providing any personally identifiable information (your name, email address, address, phone number etc.), it is required that children below the age of thirteen (13) have a parent or legal guardian complete and return (by email or regular mail) a Parental Consent Form to email@example.com or
Stephanie R Dietrich, LCSW
16852 Royal Crest Dr
Houston, TX 77058
The consent form states that by his or her signature, the child’s “Parent” or “Legal Guardian”, agrees to the collection and transfer of the child’s personally identifiable information. Completing a “Revocation of Parental Consent Form” and sending it to the email or physical mailing address above will withdraw consent. In compliance with COPPA, we are sensitive about children consulting with parents or guardians before supplying personal information or ordering anything online.
Additionally, it is our intent to comply with the Children’s Advertising Review Unit’s (CARU) Guidelines on Internet advertising with its special sensitivities concerning solicitations to children under thirteen (13). We urge parents/guardians to supervise and join their children in exploring cyberspace.
5. TRANSFER OF DATA ABROAD
If you are visiting this Site from a country other than the country in which our servers are located, your communications with us may result in the transmission of information across international borders. By using this Site and electronically communicating with us, you consent to transfers of this nature.
6. COMPLIANCE WITH LAWS AND LAW ENFORCEMENT
We cooperate with government, law enforcement officials and private parties to implement and comply with the law.
Any information about you can be disclosed by us to government, law enforcement officials or private parties as we, in our sole discretion, deem necessary or appropriate to respond to claims and legal process (including without limitation subpoenas), to safeguard our property and rights or the property and rights of a third party, to safeguard the safety of the public or any person, or to prevent or stop activity we consider to be illegal or unethical. Your information will be shared to the extent necessary in order for us to comply with ICANN's rules, regulations and policies.
To the extent we are legally allowed to do so, we will take reasonable steps to inform you in the event that we must provide your personal information to third parties as part of legal process.
7. CHANGES IN OUR PRACTICES
If we make physical changes to this Policy, we will inform you here, by email, or by means of a notice on our website home page, at least thirty (30) days prior to the application of the changes.
8. CORRECTING, UPDATING AND REMOVING PERSONAL INFORMATION
You may modify, revise or disable your account information or elect to stop receiving communications from us at any time. You may send an email to firstname.lastname@example.org or you may send mail to:
Stephanie R Dietrich, LCSW
16852 Royal Crest Dr
Houston, TX 77058
Within ninety (90) days, we will respond to your request for access or to modify or disable your information.
9. MEDICAL PRIVACY NOTICE
This Section defines how medical information concerning you may be used and released by us and how you can get access to this information. Please evaluate it carefully.
A. Who Will Follow This Notice?
Health care specialists that treat you at any of our locations, including employees, volunteers, and members of all of the departments and operating units of our organization, as well as all medical practices operated, other members of our workforce, and our business associates.
B. Your Medical Information
This Section refers to your “medical information”. This includes all information that identifies you and is related to your past, present or future physical or mental health or condition, which includes information about payment and billing for the health care services you receive from us.
C. Our Pledge Regarding Medical Information
We recognize that your medical information is personal and we are dedicated to protecting it. In order to ensure that we are providing quality care and to comply with legal requirements, we create a record of the care and services you receive. This notification pertains to all your medical information that we maintain, whether created by our staff or others.
We are required by law to provide you with this notification of our legal responsibilities and privacy practices with respect to your medical information, to follow the terms of this Privacy Notice, and to inform you in the event of a breach of the privacy or security of your unsecured medical information.
D. How We May Use and Disclose Medical Information About You
For each classification of use and disclosure, we will attempt to give some examples, although not every use or disclosure in the category will be listed.
i. For treatment. It is possible that we will use your medical information so that we and other health care providers may provide you with medical treatment or services. It is possible that other health professionals share your medical information in an effort to coordinate the different services you need. We may release your medical information to people outside of our offices and/or locations who may be involved in your medical care after you leave our care.
ii. For Payment. We may disclose your medical information so that treatment and services you receive may be billed by us to a third party. For example, your health plan may require information about the treatment you received so they will pay us for the services rendered. We may also disclose your medical insurance information to obtain prior approval from your health plan.
iii. For Healthcare Operations Purposes. We may use and release your medical information for our internal operations, such as business management, and administrative activities, legal and auditing purposes, and insurance-related activities. We may also use medical information to ensure that all of our clients receive quality care, such as evaluating our processes or to assess the performance of those caring for you. We may also release information to doctors, nurses, technicians and other personnel for review and learning purposes. We may eliminate information that identifies you from this set of information so others may use it to study healthcare and healthcare delivery without learning the client’s identity. In certain situations, we may release your medical information for the health care operations of other health care providers.
iv. Health Information Exchange. We may contribute to the Regional Health Information Organization (“RHIO”), which organizes the electronic exchange of health information among health care providers in the state where we are located. For the purposes described in this Notice, we may exchange your health information electronically through RHIO. It is your right to request that your information not be included in this exchange.
v. Individuals Involved In Your Care or Payment of Your Care. We may disclose your medical information to a friend or family member who is part of your medical care, or to someone who helped pay for your care.
vi. Notification. We may disclose your medical information to inform a family member, personal representative or another person accountable for the care of your location, general condition, or death. Additionally, we may release your medical information for certain disaster relief purposes.
vii. Contacts. We may get in touch with you to deliver appointment reminders, information about treatment alternatives, or other health related benefits and services that may be useful to you.
viii. Worker's Compensation. We may disclose medical information about you for worker’s compensation or related programs, which offer benefits for work related injuries or illnesses.
ix. Mental Health Information. State laws form specific requirements for the disclosure of mental health records. In order to release mental medical information when required by these laws we will obtain your specific permission.
x. Drug & Alcohol Treatment Records. Certain rules apply to the disclosure of certain drug and alcohol program records and we will acquire your specific approval to disclose those records as required by Federal regulation 42 CFR, Part 2.
xi. Miscellaneous. We may use or disclose your medical information without your previous consent for several other reasons. Subject to certain requirements, we may give out your medical information without prior approval for public health reasons, abuse or neglect reporting, health oversight audits or inspections, research studies, funeral arrangements, Coroner’s investigations, organ donation, and emergencies. Additionally, we may release medical information when the law necessitates in response to a request from law enforcement in specific circumstances, for specialized governmental purposes including correctional, military or national security reasons, in response to valid judicial or administrative orders or to avoid a serious health threat. Additional specific rules may apply to mental health records.
xii. Other Disclosures. Other uses and disclosures not outlined above will be made only with your written permission. For example, we require your signed approval for uses and disclosure that constitute the sale of your medical information and for most uses and disclosures of psychotherapy notes. Furthermore, we will not use or release your medical information for marketing reasons without a signed approval from you except that an approval will not be required if (a) a communication occurs face-to-face; (b) consists of marketing gifts of minimal value. You may withdraw your consent at any time unless we have relied on your approval or your approval was necessary as a condition of attaining health care services.
E. Your Rights Regarding Medical Information About You
i. Right to Inspect and Copy. In most situations, you possess the right to inspect or obtain a copy of your medical information (or have a copy given to an individual whom you designate) when you give a written request. If your medical record is kept in an electronic format in a designated record set, you possess the right to ask for a copy of the information in an electronic form and format. In certain circumstances, we may deny your request. You have the right to appeal if you are denied access to your medical information.
ii. Right to Amend. If you perceive the information in your record to be incorrect or incomplete, you have the right to ask for an addendum to be included in your record by providing a written request detailing your reason. We may not approve your request under certain situations. If we deny the request, we may inform you in writing of the reason or explain your rights to present a statement of explanation.
iii. Right to an Accounting of Disclosure. You possess the right to a list of those occasions where we have released your medical information other than for treatment, payment, healthcare operations, or where a disclosure was particularly authorized, for the Hospital’s directory, to persons involved in your care, and certain other limited situations. In order to ask for a list of disclosures, you must provide a written request to our Support Department.
iv. Right to a Paper Copy of this Notice. If you received this notice electronically, you have a right to a paper copy of this notice. You may ask that we send other communications of secure health information by alternative means or to an alternative location. This request must be provided in writing to the person listed below in Section 13. We are required to accommodate only reasonable requests. Please be specific in your correspondence about exactly how you prefer for us to communicate with you as well as if you are requesting us to send it to a particular place, including the contact/address information.
v. Right to Request Restrictions. You may request in writing that we not use or disclose your medical information except when particularly approved by you, when mandatory by law, or in an emergency. We are not mandated by law to comply with your request, but we will consider the request except in the case of certain requests related to disclosures to health plans. We will inform you of our decision.
vi. Right to Request Restrictions on Disclosures to Health Plans. You may request in writing that we restrict the release of your medical information to a health plan in order to carry out payment or healthcare operations if the disclosure is not mandated by law and the medical information relates solely to a health care item or service for which you (or a person other than the health plan who is acting on your behalf) have paid us out of pocket and in full at the time of service. We must agree to a request that meets these requirements.
F. Changes to this Notice
We maintain the right to change this Section at any time. Changes will pertain to medical information we already hold, as well as new information after the change occurs. We will post a copy of our current notice on our website at cultivatingchages.net and within our facilities.
G. Complaints and Requests
If you have questions about this notice or want to talk about a problem without filing a formal complaint, please contact Stephanie R. Dietrich, LCSW at email@example.com
H. Transfer of Business Assets
As part of our business strategy, we might acquire, buy or merge with other businesses or assets. In such transactions, customer information is generally one of the transferred business assets. Also, in the event that we, or substantially all of our assets are obtained, both personally identifiable and non-personally identifiable information will be one of the transferred assets.
Stephanie R Dietrich, LCSW
16852 Royal Crest Dr
Houston, TX 77058