THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET

ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

I. TIDAL THERAPY SOLUTIONS' PLEDGE REGARDING HEALTH INFORMATION: Tidal Therapy Solutions understands that

health information about clients and their health care is personal. The company is committed to protecting health information related

to clients. A record of the care and services provided to clients is created to ensure quality care and to comply with certain legal

requirements. This notice applies to all records of care generated by Tidal Therapy Solutions. This notice will inform clients about

the ways in which the company may use and disclose health information about them. It also describes clients' rights regarding the

health information maintained by Tidal Therapy Solutions, as well as certain obligations the company has concerning the use and

disclosure of health information.

Tidal Therapy Solutions is required by law to:

• Make sure that protected health information ("PHI") that identifies you is kept private.

• Provide you this notice or our legal duties and privacy practices with respect to your health information.

• Follow the terms of the notice that is currently in effect.

• Tidal Therapy Solutions can change the terms of this Notice, and such changes will apply to all information that we have about you. The new Notice will be available upon request, in our office and on our website: www.tidaltherapync.com.

II. HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU: The following categories describe different ways

that we use and disclose health information. Not every use or disclosure in a category will be listed. All of the way in which we are

permitted to use and disclose information about you, do fall within one of the following categories.

For Treatment Payment, or Health Care Operations: Federal privacy rules (regulations) allow health care providers who have direct

treatment relationships with the patient/client to use or disclose the patient/client's personal health information with the patient's

written authorization, to carry out the health care provider's own treatment, payment or health care operations. We may also

disclose your protected health information for the treatment activities of any health care provider. This too can be done without your

written authorization. For example, if a health care provider were to consult with another licenses health care provider about your

condition, we would be permitted to use and disclose your personal health information, which is otherwise confidential, in order to

assist the health care provider in diagnosis and treatment of your condition. Disclosures for treatment purposes are not limited to

the minimum necessary standard. Other healthcare providers need access to the full record and/or full and complete information in

order to provide quality care. The word "treatment" includes, among other things, the coordination and management of health care

providers with a third party, consultations between health care providers and referrals of a patient for health care from one health

care provider to another.

Lawsuits and Disputes: If you are involved in a lawsuit, we may disclose health information in response to a court or administrative

order. We may also disclose health information about your child in response to a subpoena, discovery request or other lawful

process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an

order protection the information requested.

We may disclose your medical information to an appropriate authority if we reasonably believe that you are the possible victim or

abuse, neglect, domestic violence or the possible victim of other crimes. We may disclose your medical information when

necessary to assist law enforcement officials to capture an individual who has admitted to participation in a crime or has escaped

from lawful custody.

We may also disclose to military authorities the medical information of Armed Forces personnel under certain circumstances. We

may disclose to authorized federal officials medical information required for lawful intelligence, counterintelligence, and other

related national security activities.

III. CERTAIN USES AND DISCLOSURES REQUIRE AUTHORIZATION:

One | Session Notes: We do keep "Session notes" and any use or disclosure of such notes requires your Authorization unless the

use or disclosure is:

a. For our use in treating you

b. For our use in training or supervising therapists to help them improve their clinical skills.

c. For use in defending ourselves or therapists in legal proceedings instituted by you.

d. For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA.

e. Required by law and the use or disclosure is limited to the requirements of such law.

f. Required by law for certain health oversight activities pertaining to the originator of the session notes.

g. Required by a coroner who is performing duties authorized by law

h. Required to help avert a serious threat to the health and safety of others.

Two | Marketing Purposes: As health care providers, we will not use or disclose your PHI for marketing purposes.

Three | Sale of PHI, as health care providers, we will not sell your PHI during the regular course of our business.

V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT.

Disclosures to family, friends or others: We may provide your PHI to a family member, friend, or other person that you indicate is

involved in your care or the payment of your healthcare services, unless you object in whole or in part. These disclosures may be

done in instances to notify, or assist in notification of your location, your general condition, or death. If you are present, then prior to

use or disclosure we will provide you with an opportunity to object to such uses or disclosures. We will disclose PHI based on a

determination using our professional judgment disclosing only protected health information that is directly relevant to the person's

involvement in your health care. The opportunity to consent may be obtained retroactively in emergency situations.

We may also use your medical information to contact you to provide appointment reminders. You can opt out of appointment

reminders by email to admin@tidaltherapync.com.

VI. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI

One | The Right to Request Limits on Uses and Disclosures of your PHI. You have the right to ask Tidal Therapy Solutions not to use

or disclose certain PHI for treatment, payment or health care operation purposes. We are not required to agree to your request and

we may say "no" if we believe it would impact your health care.

Two | The Right To Request Restrictions for Out-of-Pocket Expenses Paid for in Full. You have the right to request restrictions on

disclosures of your PHI to health plans for payment or health care operations purposes if the PHO pertains solely to a health care

item or a health care service that you have paid for out-of-pocket in full.

Three | The Right to Choose How I Send PHI to You: You have the right to ask me to contact you in a specific way (for example,

home or office phone) or to send mail to a different address and we will agree to all reasonable requests.

Four | The Right to See and Get Copies of Your PHI. Other than "session notes," you have the right to get an electronic or paper

copy of your medical record and other information that we have about you. We will provide you with a copy of your record, or a

summary of it, if you agree to receive a summary, within 30 days of receiving your written request. We may also charge a

reasonable, cost based fee for doing so.

Five | The Right to Get a List of the Disclosures We Have Made. You have the right to request a list of instances in which we have

disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided us an

Authorization. We will respond to your request for an accounting of disclosures within 60 days of receipt of you request. The list that

we will provide you will include disclosures made in the last six years unless you request a shorter duration. We will provide this list

at no charge, however additional lists requested within the same calendar year will be subject to a reasonable charge per

additional request.

SIX | The Right to Correct or Update your PHI. If you believe that there is a mistake contained in your PHI, or that a piece of

important information is missing from your PHI, you have the right to request Tidal Therapy Solutions to correct the information or

add the missing information. We reserve the right to say "no" to your request, in such case we will notify you in writing as to the

reason why within 60 days of receiving your request.

SEVEN | The Right to Get a Paper or Electronic Copy of this Notice. You reserve the right to obtain a paper copy of this Notice as

well as the right to obtain a copy of this notice by e-mail. This right is maintained even in a case where you have agreed to receive

this notice via e-mail, you still maintain the right to request a paper copy of it.

QUESTIONS AND COMPLAINTS DISCLOSURE

If you want additional information about our Privacy Practices, have questions or concerns, please contact Tidal Therapy Solutions

by utilizing the information listed at the end of this notice.

If you are concerned that we may have violated your privacy rights, or disagree with a decision that we have made regarding your

medical information or in response to a request you made to add, amend, or restrict the use or disclosure of your medical

information or to have us communicate with you by alternative means, you may complain to us by utilizing the contact information

listed at the en of this notice. You also may submit a written complaint to the U.S. Department of Health and Human Services upon

request.

We support your right to the privacy of your medical information. We will not retaliate in any manner if you choose to file a complaint

to the U.S. Department of Health and Human Services.

Contact:

Tidal Therapy Solutions

Telephone: 910-541-3636

Email: outreach@tidaltherapync.com

Mailing Address:

Tidal Therapy Solutions LLC 

2761 NC HWY 210 E | ST G #102 

Hampstead, North Carolina 28443 

Effective as of January 01, 2025