HIPAA Notice of

Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.

I. Our Pledge regarding Protected Health Information ("PHI")

The Golden Thread Therapy, LLC ("TGTT"), understands that PHI about you and your health is personal. We are committed to protecting health information about you. "Protected health information" or "PHI" refers to information in your health record that identifies you or could reasonably be used to identify you, which TGTT keeps or transmits in electronic; oral; or written form. PHI may include information such as your name; contact information; past, present, or future physical or mental health; payment for healthcare products or services; and/or prescriptions. TGTT creates a record of the care and health services you receive to provide your care and to comply with certain legal requirements. Accordingly, this Notice applies to all records of your care generated by TGTT, whether by TGTT personnel or your personal doctor or other healthcare provider.

II. Purpose of this Notice

This Notice describes: 1) our legal duties and privacy practices regarding your PHI, including our duty to notify you following a data breach of your unsecured PHI; 2) our permitted uses and disclosures of your PHI; and 3) your rights regarding your PHI.

We can change the terms of this Notice, and the changes will apply to all information we have about you. The new notice will be available on request; in our office; and on our website.

III. Definitions of Terms used in this Notice

For clarity, please refer to the definitions below:

  • "Healthcare Operations" involve the administrative and professional activities required to run TGTT's practice, including quality review; training; licensing requirements; and business planning.

  • "Protected Health Information" (or "PHI") refers to to information in your health record that identifies you or could reasonably be used to identify you, which TGTT keeps or transmits in electronic; oral; or written form. PHI may include information such as your name; contact information; past, present, or future physical or mental health or mental conditions; payment for healthcare products or services; and/or prescriptions.

  • "TGTT" refers to The Golden Thread Therapy, LLC, as well as its clinical and non-clinical support personnel.

  • "Treatment" includes the mental health services TGTT provides to you, as well as coordination or management of care with other professionals when appropriate (for example, consulting with another provider involved in your care).

  • For the purposes of this Notice, the term "Medical" as it relates to treatment; care; and/or services shall expressly include mental or behavioral health, unless stated otherwise.

  • For the purposes of this Notice, the terms "Client" and "Patient" shall have the same meaning and shall be used interchangeably.

IV. Uses and Disclosure of PHI

The law permits or requires us to use or disclose your PHI for various reasons. We may share your information in other ways, in accordance with applicable law and regulations. For more information on permitted uses and disclosures, please see the US Department of Health and Human Services' resource regarding your rights under HIPAA. The following categories describe different ways that we use and disclose PHI without your written authorization:

1. For Treatment: We may use PHI about you to provide you with, coordinate, or manage your medical treatment or services. We may disclose PHI about you to doctors, nurses, technicians, or other personnel who are involved in taking care of you. TGTT staff may also share PHI about you in order to coordinate the different things you need, such as prescriptions and lab work. We also may disclose PHI about you to people outside TGTT’s office who may be involved in your medical care. We may use and disclose PHI to contact you as a reminder that you have an appointment for treatment or medical care at TGTT. We may use and disclose PHI to tell you about or recommend possible treatment options or alternatives or health-related benefits or services.

2. For Payment for Services: We may use and disclose PHI about you so that the treatment and services you receive at TGTT may be billed to and payment may be collected from you, an insurance company or a third party, as applicable.

3. For Healthcare Operations: We may use and disclose PHI about you for TGTT healthcare operations, such as our quality assessment and improvement activities; case management; coordination of care; business planning; customer services; and other activities. These uses and disclosures are necessary to run the practice, reduce health care costs, and make sure that all of our patients receive quality care. We may also combine PHI about many TGTT patients to decide what additional services TGTT should offer; what services are not needed; and whether certain new treatments are effective. We may also disclose information to TGTT’s health care personnel for review and learning purposes. Subject to applicable state law, in some limited situations the law allows or requires us to use or disclose your health information for purposes beyond treatment; payment; and operations. However, some of the disclosures set forth below may never occur at our practice.

4. For Individuals Involved in Your Care: Your PHI may be used and disclosed to your designated emergency contact with your written consent and permission. If you are unavailable; incapacitated; and/or facing an emergency medical situation and your therapist determines that a limited disclosure may be in your best interest, your therapist may share the minimum necessary PHI with your emergency contact without your approval. If you are a person between 14 and 18 years of age, your therapist may also need to share the minimum necessary PHI in case of emergency and/or referral to a higher level of care. Your therapist may also disclose limited PHI to a public or private entity that is authorized to assist in disaster relief efforts for that entity to locate a family member or other person/s that may be involved in some aspect of caring for you.

5. As Required By Law: We will disclose PHI about you when legally required to do so by federal, state or local law or regulations.

6. Health Risks: We may disclose PHI about you to a government authority if we reasonably believe you are a victim of abuse, neglect, or domestic violence. Health Risks shall expressly include the following:

  • Child Abuse: if TGTT has reasonable cause to suspect that a child is a victim of child abuse, TGTT is required by law to report this to the appropriate authority.

  • Elderly Abuse or Abuse of Vulnerable Persons: If TGTT has reasonable cause to believe that an older adult (60 years of age or older) or vulnerable person is being abused, TGTT is required by law to report this to the appropriate authority.

  • Serious Thread to Health or Safety: If, in the professional judgment of TGTT's personnel, there is believed to be a significant risk that you may cause harm to yourself or to another person, TGTT may disclose relevant information to appropriate individuals or authorities as necessary to help prevent that harm.

  • Impaired Driving: Clients are expected to attend sessions in a state that allows for safe and effective participation. If a client presents to session while impaired (e.g., due to alcohol or substance use) and intends to operate a motor vehicle or otherwise place themselves or others at risk, the Company will require that alternative transportation be arranged. If the client refuses and there is a reasonable concern for safety, the Company is required to notify the authorities to ensure public safety and prevent harm.

7. Business Associates: We may disclose information to business associates who perform services on our behalf (such as billing companies). However, all such business associates are required to appropriately safeguard your information.

8. Health Oversight Activities: We may disclose health information to a health oversight agency for activities authorized by law. These activities include audits; investigations; and inspections, which may be necessary for licensure and for the government to monitor the health care system; government programs; and compliance with civil rights laws.

9. Law Enforcement and Legal Proceedings: If you are involved in a legal matter and information is requested about your treatment or records, your information is generally protected by therapist-client privilege under Pennsylvania law and will not be released without your written authorization or a valid court order. To the extent that we have your substance use disorder treatment or patient records, subject to 42 CFR part 2, we will not share that information for investigations or legal proceedings against you without (1) your written consent or (2) a court order and a subpoena. There are certain exceptions to this privilege (such as when services are court-ordered or conducted for a third-party evaluation), in which case different rules may apply. TGTT may release PHI as and when required by law. Information about you will not be disclosed unless TGTT is legally required to do so. In accordance with applicable law, we may also disclose health information about your minor child/ren in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute. We will only disclose this information if we have made efforts to tell you about the request or in the pursuit of obtaining an order to protect your information.

10. Research: For research purposes, including studying and comparing the mental health of clients who received one form of therapy versus those who received another form of therapy for the same condition. Any such information shared for research purposes shall be in accordance with applicable law.

11. Special Government Functions: If you are a member of the armed forces, we may release PHI about you if it relates to military and veterans’ activities, in accordance with applicable law.

12. Worker’s Compensation: We may disclose information as necessary to comply with laws relating to worker’s compensation or other similar programs established by law.

V. Uses and Disclosures regarding Your Authorization

The following categories describe uses and disclosures of your information which require your authorization, as well as exceptions to when you must provide authorization. For each category of uses or disclosures, we will explain what we mean and give examples. Not every use or disclosure will be listed. However, all the uses and disclosures of your information requiring your authorization will fall within one of these categories:

1. Psychotherapy Notes.TGTT may keep psychotherapy notes, as that term is defined under federal regulations (45 CFR § 164.501). Any use or disclosure of such psychotherapy notes requires your authorization unless the use or disclosure is:

  • For our use in treating you;

  • For our use in training or supervising mental health practitioners to help them improve their skills in group; couple’s; family; or individual psychotherapy;

  • For our use in defending ourselves in legal proceedings instituted by you;

  • For use by the Secretary of Health and Human Services to investigate our compliance with HIPAA;

  • Required by law, and the use or disclosure is limited to the requirements of such law;

  • Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes;

  • Required by a coroner who is performing duties authorized by law; and/or

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

2. For Individuals Involved in Your Care: As set forth previously, your PHI may be used and disclosed to your designated emergency contact with your written consent and permission. If you are unavailable; incapacitated; and/or facing an emergency medical situation and your therapist determines that a limited disclosure may be in your best interest, your therapist may share the minimum necessary PHI with your emergency contact without your approval. If you are a person between 14 and 18 years of age, your therapist may also need to share the minimum necessary PHI in case of emergency and/or referral to a higher level of care. Your therapist may also disclose limited PHI to a public or private entity that is authorized to assist in disaster relief efforts for that entity to locate a family member or other person/s that may be involved in some aspect of caring for you.

TGTT will never use, disclose, or sell your PHI for marketing purposes.

VI. Your Choices

For certain health information, you can tell us your choices about what we share. You have both the right and choice to tell us whether to, or not to, share information with your family, close friends, or others involved in your care, as well as in a disaster relief situation. Please contact us and let us know your preferences, and we will make reasonable efforts to follow your requests.

VII. Data Breach Notification

We will promptly notify you if a data breach occurs that may have compromised the privacy or security of your PHI. We will notify you within the legally required time frame (i.e., no later than 60 days after we discover the breach).

VIII. Your Rights regarding PHI about You

You have the following rights regarding PHI we maintain about you:

1. Right to Inspect and Copy: You have the right to inspect and copy PHI that may be used to make decisions about your care. Usually, this includes medical and billing records. To inspect and copy PHI that may be used to make decisions about you, you must submit your request in writing to TGTT. If you request a copy of the information, we may charge a fee for the costs of copying; mailing; or other supplies associated with your request, and we will respond to your request no later than 30 days after receiving it. You may request that we provide a copy of your PHI to a family member, another person, or a designated entity. In this case, we require that you submit these requests in writing with your signature, and clearly identify the designated person and where to send the PHI. We may deny your request for access in certain limited circumstances. However, if we deny your access request, we will provide you with a written denial containing the basis for our decision and explain your rights to appeal or file a complaint.

2. Right to Correct Your PHI: You may ask us to correct or amend PHI that we maintain about you that you think is incorrect or inaccurate. For these requests, you must submit these requests in writing; specify the inaccurate or incorrect PHI; and provide a reason that supports your request. We may deny your request for an amendment if you ask us to amend PHI that is not part of our record, that we did not create, that is not part of a designated record set, or that is accurate and complete. If we deny your request, we will tell you why in writing within 60 days of receiving your request. You will have the right to submit a written statement disagreeing with the denial and, if you opt not to submit this statement, you may request that we provide your original request for amendment and the denial with any future disclosures of PHI subject to the amendment. However, we may prepare a written rebuttal to any individual’s statement of disagreement, if we deem it to be necessary. We will append the material created or submitted in accordance with this paragraph to your designated record.

3. Right to an Accounting of Disclosures: You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of PHI about you. To request this list or accounting of disclosures, you must submit your request in writing to TGTT. TGTT will respond to your request within 60 days of receiving your request. We will provide this list at no charge. However, if you make more than one request in the same calendar year, we reserve the right to charge a reasonable, cost-based fee for each additional request. You may ask for disclosures made up to six years before your request. We are required to provide a listing of all disclosures except the following:

  • For your treatment;

  • For billing and collection of payment for your treatment;

  • For healthcare operations;

  • Made to or requested by you, or that you authorized;

  • Occurring as a byproduct of permitted use and disclosures;

  • As part of a limited data set of information that does not contain information identifying you

4. Right to Request Restrictions: You have the right to request a restriction or limitation on the PHI we use or disclose about you for treatment, payment or health care operations or to persons involved in your care. We are not required to agree to your request. We may deny your request if: 1) it would affect your care; 2) the information is needed to provide you emergency treatment; 3) the disclosure is to the Secretary of the Department of Health and Human Services; or 4) it is required under applicable law. To request restrictions, you must make your request in writing to TGTT.

5. Right to Request Restrictions for Out-of-Pocket Expenses Paid by You In Full: You have the right to request restrictions on disclosures of your PHI to health plans for payment or healthcare operations purposes if the PHI pertains solely to a healthcare item or healthcare service you have paid for out-of-pocket in full.

6. Right to Request Confidential Communications and Choose How We Send PHI to You: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. You have the right to ask us to contact you in a specific way (for example, your mobile phone as opposed to your home phone) or to send mail to a different address. We will agree to all reasonable requests.

7. 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 PHI. We will confirm the person has this authority and can act for you before we take any action.

8. Right to Receive a Copy of this Privacy Notice: You have the right to receive a copy of this Notice in paper and/or electronically. Even if you have agreed to receive this Notice electronically, you still have the right to also request a paper copy of this Notice. You can receive a copy of this Notice upon request. This Notice will also be available in our office and on our website

9. Right to File a Complaint: You have the right to complain if you feel we have violated your rights. We will not retaliate against you for filing a complaint. You may either file a complaint:

  • Directly with us by contacting MC Mazzocchi, LSCW, by email at admin@tgt-therapy.com. All complaints must be submitted in writing; or

  • With the Office for Civil Rights at the U.S. Department of Health and Human Services. You may:

    • Send a letter to Centralized Case Management Operations, U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Room 509F HHH Bldg., Washington, D.C. 20201;

    • email OCRComplaint@hhs.gov; or

    • file electronically through the Online Portal.

For more information on the complaint process, please visit the US Department of Health and Human Services' resource on filing complaints.

IX. Effective Date, Restrictions, and Changes to the Privacy Policy

This Notice shall be effective as of 06/22/2026.

TGTT reserves the right to change the terms of this Notice and apply such changes to all PHI that TGTT maintains. If a revision is implemented, TGTT will make such revisions available to you in TGTT’s office and on the TGTT website. A revised Notice may be provided to you upon request.

TGTT is required to abide by the terms of this Notice currently in effect. TGTT reserves the right to modify the terms of this Notice and to apply such changes to all PHI maintained by the TGTT’s practice, as permitted by law. Any revisions will be made available to you on request or in our office and on our website.