Notice of Privacy Practices

Effective date: July 19, 2026

This Notice applies to protected health information maintained by Rebecca Martel, APRN, FNP-BC, doing business as Certicare, and workforce members or clinicians who lawfully participate under this Notice. “We” and “Certicare” refer to those persons for purposes of this Notice.

6.1 Your rights

Get an electronic or paper copy of your record

You may ask to inspect or receive an electronic or paper copy of your medical record and other health information we maintain about you. We will usually provide a copy or summary within 30 days after a valid request. Standard electronic copies are free under Certicare’s policy. We may charge a reasonable, cost-based amount for paper copies, special media, or special delivery when law permits and will tell you in advance.

Ask us to correct your record

You may ask us to amend information you believe is incorrect or incomplete. We may deny the request in circumstances permitted by law, but we will explain a denial in writing, generally within 60 days, and tell you about any further rights.

Request confidential communications

You may ask us to contact you in a particular way or at a different address. We will agree to reasonable requests. Tell us clearly which method or address is safe for you.

Ask us to limit uses or disclosures

You may ask us not to use or disclose certain information for treatment, payment, or health care operations. We are not always required to agree. If you paid for a service in full out of pocket and ask us not to disclose it to a health plan for payment or operations, we will agree unless disclosure is required by law.

Get an accounting of disclosures

You may ask for a list of certain disclosures made during the six years before your request, including who received the information and why. The list does not include disclosures for treatment, payment, or health care operations and certain other disclosures. One accounting in a 12-month period is free; a reasonable cost-based fee may apply to an additional accounting after advance notice.

Get this Notice, choose a representative, and complain

You may request a paper copy of this Notice even if you accepted it electronically. A person with legal authority to act for you may exercise your rights after we verify that authority. You may complain to Certicare or to the U.S. Department of Health and Human Services Office for Civil Rights if you believe your privacy rights were violated. We will not retaliate against you.

6.2 Your choices

You may tell us whether to share relevant information with family, close friends, or others involved in your care or payment, and for disaster relief. If you cannot tell us your preference, we may share information when we believe it is in your best interest or needed to reduce a serious and imminent threat, as permitted by law.

We will obtain written permission for uses and disclosures that require it, including marketing that uses protected health information, sale of protected health information, and most uses or disclosures of psychotherapy notes. Certicare does not sell protected health information. If you authorize a disclosure, you may revoke the authorization in writing for future disclosures, except to the extent action has already been taken.

6.3 How we typically use and disclose information

Treatment

We may use your health information and share it with other health professionals involved in your care. For example, we may send relevant information with a referral or discuss a medication concern with a pharmacy.

Health care operations

We may use and disclose information to run the practice, manage services, improve quality, train workforce members, conduct audits, address complaints, obtain legal or professional advice, secure systems, and contact you when necessary.

Payment

We may use and disclose information to collect payment, process refunds, address charge inquiries, and manage financial records. Certicare is self-pay and does not submit insurance claims as part of the current service model.

6.4 Other uses and disclosures allowed or required by law

After meeting applicable legal conditions, we may use or disclose health information for public health and safety activities; reporting adverse events, abuse, neglect, or domestic violence; health oversight; research; organ donation; coroners, medical examiners, and funeral directors; workers’ compensation; law enforcement; special government functions; judicial or administrative proceedings; compliance with law; and prevention or reduction of a serious threat to health or safety. We follow stricter state or federal protections when they apply.

6.5 Employer and leave documentation

Preparing a document for you does not authorize us to send it to an employer. You normally control delivery. We disclose a document directly to an employer, leave administrator, or similar recipient only under a valid, case-specific authorization or another lawful basis. We disclose only the information authorized or otherwise permitted.

6.6 Substance use disorder records

To the extent we receive or maintain substance use disorder patient records protected by 42 CFR Part 2, those records receive the additional protections required by federal law. We will not use or disclose Part 2 records in a civil, criminal, administrative, or legislative investigation or proceeding against you unless you give the required written consent or a qualifying court order and subpoena are obtained. If fundraising would use Part 2 information, we will provide clear advance notice and a choice as required by law.

6.7 Our responsibilities

• We are required by law to maintain the privacy and security of protected health information.
• We will notify you as required if a breach may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices in the Notice currently in effect and provide a copy upon request.
• We will not use or disclose information other than as described here unless you authorize it in writing or law otherwise permits or requires it.

6.8 Changes to this Notice

We may change this Notice, and the revised terms may apply to information we already maintain as well as information received later. The current Notice will be posted prominently on our website and available upon request. The effective date appears at the top.

6.9 Privacy requests and complaints

Contact Certicare at privacy@certicare.org, 518-254-8905, or 418 Broadway, Albany, NY 12207. We acknowledge complaints within one business day, although investigation and resolution may take longer. You may also complain to the U.S. Department of Health and Human Services Office for Civil Rights, 200 Independence Avenue SW, Washington, DC 20201, 1-877-696-6775, or hhs.gov/hipaa/filing-a-complaint. We will not retaliate.