Notice of Privacy Practices

Effective Date: November 10, 2026

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.

Our Commitment to Your Privacy

Wonderland Behavioral & Mental Health, LLC is required by law to maintain the privacy and security of your protected health information (PHI), to give you this notice of our legal duties and privacy practices, to follow the terms of the notice currently in effect, and to notify you promptly if a breach occurs that may have compromised the privacy or security of your information.

Your Rights

When it comes to your health information, you have certain rights. You may:

• Get a copy of your health record. You can ask to see or get an electronic or paper copy of your health record. We will usually provide it within 30 days of your request. We may charge a reasonable, cost-based fee.
• Ask us to correct your health record. You can ask us to correct health information you think is incorrect or incomplete. We may say “no,” but we will tell you why in writing within 60 days.
• Request confidential communications. You can ask us to contact you in a specific way (for example, by cell phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
• Ask us to limit what we use or share. You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree, and we may say “no” if it would affect your care. If you pay for a service or health care item out of pocket in full, you can ask us not to share that information with your health insurer, and we will say “yes” unless a law requires us to share it.
• Get a list of those with whom we have shared information. You can ask for a list (accounting) of the times we have shared your health information for six years prior to the date you ask, who we shared it with, and why.
• Get a copy of this notice. You can ask for a paper copy of this notice at any time.
• 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.
• File a complaint if you feel your rights are violated. You can contact our Privacy Officer using the information below, or 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/complaints. We will not retaliate against you for filing a complaint.

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 to share information with your family, close friends, or others involved in your care, or to share information in a disaster relief situation. If you are not able to tell us your preference, for example if you are unconscious, we may share your information if we believe it is in your best interest, or when needed to lessen a serious and imminent threat to health or safety.

We never share your information for marketing purposes or sell your information unless you give us written permission. We do not conduct fundraising.

How We Typically Use or Share Your Health Information

• Treatment. We can use your health information and share it with other professionals who are treating you, such as your primary care provider, therapist, or a hospital.
• Running our practice. We can use and share your health information to run our practice, improve your care, and contact you when necessary, such as appointment reminders.
• Billing for your services. We can use and share your health information to bill and get payment from health plans or other entities.

Other Ways We May Use or Share Your Health Information

We are allowed or required to share your information in other ways, usually in ways that contribute to the public good. We must meet many conditions in the law before we can share your information for these purposes:

• Helping with public health and safety issues, such as reporting suspected abuse, neglect, or domestic violence, and preventing or reducing a serious threat to anyone’s health or safety
• Complying with the law, including if the U.S. Department of Health and Human Services wants to see that we are complying with federal privacy law
• Doing research, when approved through a privacy review process
• Responding to organ and tissue donation requests and working with a medical examiner or funeral director
• Addressing workers’ compensation, law enforcement, and other government requests, including health oversight agencies and special government functions such as military and national security
• Responding to lawsuits and legal actions, such as a court order or subpoena

Special Protections

• Psychotherapy notes. Psychotherapy notes are kept separately from your medical record and receive extra protection. Most uses and disclosures of psychotherapy notes require your written authorization.
• Substance use disorder treatment records. If we receive records from a federally assisted substance use disorder treatment program protected by 42 C.F.R. Part 2, those records will not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless you give written consent or a court order is issued after notice and an opportunity to be heard, as required by law.
• Georgia law. Georgia law may provide additional protections for mental health information, information about minors, HIV/AIDS information, and other sensitive information. When state law is more protective of your privacy than federal law, we follow the more protective law.
• Minors. In most cases, a parent or legal guardian may exercise the rights described in this notice on behalf of a minor patient, except where state or federal law allows a minor to control their own health information.

Other Uses Require Your Written Permission

Uses and disclosures not described in this notice will be made only with your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted on it.

Changes to This Notice

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 upon request, in our office, and on our website.

Contact Us

If you have questions about this notice or wish to exercise any of your rights, please contact:

Privacy Officer: Joan Bourne, DNP, MSW, PMHNP-BC
Wonderland Behavioral & Mental Health, LLC
1815 Lockeway Dr, Suite 105, Alpharetta, GA 30004
Phone: (770) 284-6472 | Email: admin@wonderlandbmh.com