Notice of Privacy Practices
Effective Date: March 25, 2026
PURPOSE OF THIS NOTICE
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. If you have any questions about this document, please contact Oasis Mental Health, PC at (541) 636-9846.
WHO WILL FOLLOW THIS NOTICE
This Notice describes the privacy practices followed by healthcare providers and staff of Oasis Mental Health, PC. This also includes any health care professional authorized to enter information into your medical record created and/or maintained within our office. This notice applies to all employees, students, residents and other service providers who have access to your health information within the office who are allowed to use or disclose your protected health information (PHl).
YOUR HEALTH INFORMATION
This Notice applies to the information and records we have about your mental health or conditions and the services you receive within our office. Your health information may include information created and received by this office and may be in the form of written or electronic records or spoken words. lt may include information about your health history, health status, mental health status, condition, symptoms, examinations, test results, diagnosis treatments, procedures, prescriptions, related billing activity, and similar types of health related information. We are required by law to maintain the privacy of your health information and to provide you with this Notice. lt will tell you about ways in which we may use and disclose health information about you and describe your rights and our obligations regarding the use and disclosure of that information.
HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
ln certain situations, we must obtain your written authorization in order to use and/or disclose your health information. We may, however, use and disclose your health information without your authorization for the following purposes:
Treatment. We may use and/or disclose your health information to provide medical treatment, mental health treatment and other health care services to you. We may disclose health information about you to doctors, nurse practitioners, physician assistants, pharmacists, psychologists, counselors, case managers, nurses, students, residents, technicians, volunteers, office staff, or other personnel who are involved in taking care of you and your health. Personnel in our office may share health information about you and disclose information to people who do not work in our office in order to coordinate your care, such as a school counselor who is working with your child. Family members and other health care providers may be part of your medical care outside this office and may require information about you that we have.
Payment. We may use and disclose your health information to bill and obtain payment from your insurance for services that we provide to you. We will obtain your authorization to disclose health information to your private health insurer, HMO, private payer, or another third party. We may also disclose health information to your health plan in order to obtain prior approval for the services we provide, or to determine whether your health plan will pay for the treatment.
Health Care Operations. We may use and disclose your PHI to operate this medical practice. For example, we may use and disclose this information to review and improve the quality of care we provide, or the competence and qualifications of our professional staff. We may also use and disclose this information to get your health plan to authorize services or referrals. We may also use and disclose this information as necessary for medical reviews, legal services, and audits, including fraud and abuse detection compliance programs, and business planning and management. We may also share your medical information with our “business associates,” such as a billing service, that performs administrative services for us. We have a written contract with each of these business associates that contains terms requiring them to protect the confidentiality of your medical information.
Appointment Reminders. We may contact you by phone or SMS text as a reminder that you have an upcoming appointment with our office. SMS consent is not shared with third parties. Please notify us in writing at the address listed on the front page of this Notice if you do not wish to be contacted for telephone appointment reminders.
Disclosure to Relatives, Close Friends and Other Caregivers. We may use or disclose your health information to a family member, other relative, a close personal friend, or any other person identified by you when you are present for, or otherwise available prior to the disclosure, if we: 1. Obtain your verbal agreement to do so; 2. Provide you with the opportunity to object to the disclosure and you do not raise an objection; 3. Based on our professional judgment that you would not object to the disclosure. If you are not present, or the opportunity to agree or object to a use or disclosure cannot practicably be provided because of your incapacity or an emergency circumstance, we may exercise our professional judgment to determine whether a disclosure is in your best interests. In the event of an emergency, we may disclose information to public service organizations to facilitate your care. We may disclose your PHI even though you object if we believe it is necessary to respond to emergency circumstances. lf we do disclose information to any of the people listed above, we would disclose only information that we believe is directly relevant to the person's involvement with your health care or payment related to your health care. We may also disclose your PHI in order to notify (or assist in notifying) such persons of your location, general condition, or death.
HIPAA-Compliant Software. Our electronic medical record and software used for video conferencing (also called “telemedicine,” “telepsychiatry, “ or “telehealth”) are digitally secured and HIPAA-compliant. No recordings are made of telemedicine visits.
OTHER PERMITTED OR REQUIRED USES AND DISCLOSURES OF HEALTH INFORMATION
Public Safety. We may, and are sometimes required by law to disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury, or disability; reporting child, elder, or dependent adult abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problems with products and reactions to medications, and reporting disease or infection exposure. When we report suspected elder or dependent adult abuse or domestic violence, we will inform you or your personal representative promptly unless in our best professional judgment we believe the notification would place you at risk of serious harm or would require informing a personal representative we believe is responsible for the abuse or harm.
Lawsuits and Disputes. lf you are involved in a lawsuit or dispute, we may disclose health information about you in response to a court or administrative order. Subject to all applicable legal requirements, we may also disclose health information about you in response to a subpoena.
Law Enforcement Officials. We may disclose your health information to the police or other law enforcement officials as required or permitted by law or in compliance with a court order, Grand Jury, or administrative subpoena.
Health or Safety. We may use or disclose your health information to prevent or lessen a serious and imminent threat to a person or the public's health and safety.
Specialized Government Functions. We may use and disclose your health information for military or national security purposes or to correctional institutions or law enforcement officers that have you in their lawful custody.
Workers’ Compensation. We may disclose your health information as necessary to comply with workers’ compensation laws.
Information Not Personally Identifiable. We may use or disclose health information about you in a way that does not personally identify you or reveal who you are.
Minors. If you are an unemancipated minor under Oregon law, there may be circumstances in which we disclose health information about you to a parent, guardian, or other person acting in loco parentis (“in place of the parent”), in accordance with our legal and ethical responsibilities. Minors 14 years and older may independently consent for outpatient mental health treatment. For additional information see “Minor Rights: Access and Consent to Health Care “ by the Oregon Department of Health at http://public.health.oregon.gov/HealthPeopleFamilies/Youth/Documents/MinorConsent.pdf.
Change of Ownership. In the event that this medical practice is sold or merged with another organization, your health information/record will become the property of the new owner, but you will maintain the right to request that copies of your health information be transferred to another physician or medical group.
As required by law. We may use and disclose your PHI when required to do so by federal, state, or local law.
USE AND DISCLOSURES REQUIRING YOUR WRITTEN AUTHORIZATION
For any purpose other than the ones described above, we may only use or disclose your health information when you give us your written authorization. You may revoke your authorization in writing at any time. However, information previously released cannot be un-released.
Private Payers. We must obtain your authorization to disclose health information to your HMO, health insurer, or other private payer. This authorization is contained within the Billing Agreement.
Uses and Disclosures of Your Highly Confidential lnformation. ln addition, Federal and Oregon law requires special privacy protections for "Highly Confidential lnformation" which includes: 1. Psychotherapy Notes, 2. Mental Health and Developmental Disabilities Services, 3. Alcohol and Drug Abuse Prevention and Treatment Program Services, 4. HIV/AIDS Testing, 5. Sexually
Transmitted Diseases, 6. Child Abuse and Neglect, 7. Sexual Assault, and 8. Genetic Testing. We use and disclose "Highly Confidential lnformation" with your knowledge and limited by a particular purpose.
YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
Right to Request Additional Restrictions. You may request restrictions on our use and disclosure of your health information, such as: 1. For treatment, payment and health care operations; 2. To individuals (such as a family member, or other relative, close personal friend or any other person identified by you) involved with your care or with payment related to your care; or 3. To notify or assist in the notification of such individuals regarding your location and general condition. While we will consider all requests for additional restrictions carefully, we are not required to agree to a requested restriction. lf you wish to request additional restrictions, please submit your request in writing. We will send you a written response.
Right to Receive Confidential Communications. You may request, and we will accommodate any reasonable written request for you to receive your health information by alternative means of communication or at alternative locations.
Right to Revoke Your Authorization. You may revoke your authorization, except to the extent that we have taken action in reliance on it, by delivering a written, signed revocation statement to the address listed at the beginning of this Notice.
Right to lnspect and Copy Your Health lnformation. You have the right to inspect and copy your health information. Under limited circumstances, we may deny your request. For example, we will deny your request to access your child’s records if we believe allowing access would be reasonably likely to cause substantial harm to your child. lf you desire access to your records, please submit a written request detailing what information you want access to and whether you want to inspect it or get a copy of it. lf you request copies, we will charge you a reasonable fee for each page. We will also charge you for our postage costs if you request that we mail the copies to you.
Right to Amend Your Records. You have a right to request that we amend your health information if you believe it is incorrect or incomplete. You must make a request to amend in writing and include the reasons you believe the information is inaccurate or incomplete. We are not required by law to change your health information and in this situation we will provide you with information about our denial and how you can disagree with the denial. We may deny your request if we do not have the information, if we did not create the information, if you would not be permitted to inspect or copy the information at issue, or if we believe the information is accurate and complete as is. You also have the right to request that we add to your record a statement of up to 250 words concerning any item you believe to be incomplete or incorrect.
Right to Receive an Accounting of Disclosures. You have the right to request an "Accounting of Disclosures." This is a list of the disclosures we made of medical information about you for purposes other than treatment, payment, healthcare operations, and a limited number of special circumstances involving national security, correctional institutions, and law enforcement. The list will also exclude any disclosures we have made based on your written authorization. To obtain this list, you must make a request in writing to our office. lt must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in which form you want the list (on paper, electronically, etc.). The first list you request within a 12-month period will be free. For additional lists, we may charge you for the cost of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at the time before any costs are incurred. We will charge you a reasonable fee for each page of the accounting statement.
Right to Receive Paper Copy of This Notice. Upon request, you may obtain a paper copy of this Notice.
For Further lnformation or Complaints. lf you desire further information about your privacy rights, are concerned that we have violated your privacy rights, or disagree with a decision that we made about access to your health information, you may contact the designated Privacy Officer, Kelly Henry, PMHNP. All complaints must be submitted in writing. You may also file written complaints with the Director at the Office for Civil Rights of the U.S. Department of Health and Human Services. Upon request, the Privacy Officer will provide you with the correct address for the Director. We will not retaliate against you if you file a complaint with us or the Director.
Right to Change Terms of This Notice. We may change the terms of this Notice at any time. lf we change this Notice, we may make the new Notice terms effective for all Protected Health lnformation that we maintain, including any information created or received prior to issuing the new Notice. lf we change this Notice, we will post an announcement of the change in our office with information on how to obtain the new Notice. You may also obtain any new Notice by contacting Oasis Mental Health, PC at the address listed on the first page of this Notice.
SMS Terms of Service. By opting into SMS from a web form or other medium, you are agreeing to receive SMS messages from Oasis Mental Health, PC. This includes SMS messages for conversations (external). Message frequency varies. Message and data rates may apply. See privacy policy at [http://www.oasismh.com/privacy.html]. Message HELP for help. Reply STOP to any message to opt out.
Effective Date: March 25, 2026
PURPOSE OF THIS NOTICE
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. If you have any questions about this document, please contact Oasis Mental Health, PC at (541) 636-9846.
WHO WILL FOLLOW THIS NOTICE
This Notice describes the privacy practices followed by healthcare providers and staff of Oasis Mental Health, PC. This also includes any health care professional authorized to enter information into your medical record created and/or maintained within our office. This notice applies to all employees, students, residents and other service providers who have access to your health information within the office who are allowed to use or disclose your protected health information (PHl).
YOUR HEALTH INFORMATION
This Notice applies to the information and records we have about your mental health or conditions and the services you receive within our office. Your health information may include information created and received by this office and may be in the form of written or electronic records or spoken words. lt may include information about your health history, health status, mental health status, condition, symptoms, examinations, test results, diagnosis treatments, procedures, prescriptions, related billing activity, and similar types of health related information. We are required by law to maintain the privacy of your health information and to provide you with this Notice. lt will tell you about ways in which we may use and disclose health information about you and describe your rights and our obligations regarding the use and disclosure of that information.
HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
ln certain situations, we must obtain your written authorization in order to use and/or disclose your health information. We may, however, use and disclose your health information without your authorization for the following purposes:
Treatment. We may use and/or disclose your health information to provide medical treatment, mental health treatment and other health care services to you. We may disclose health information about you to doctors, nurse practitioners, physician assistants, pharmacists, psychologists, counselors, case managers, nurses, students, residents, technicians, volunteers, office staff, or other personnel who are involved in taking care of you and your health. Personnel in our office may share health information about you and disclose information to people who do not work in our office in order to coordinate your care, such as a school counselor who is working with your child. Family members and other health care providers may be part of your medical care outside this office and may require information about you that we have.
Payment. We may use and disclose your health information to bill and obtain payment from your insurance for services that we provide to you. We will obtain your authorization to disclose health information to your private health insurer, HMO, private payer, or another third party. We may also disclose health information to your health plan in order to obtain prior approval for the services we provide, or to determine whether your health plan will pay for the treatment.
Health Care Operations. We may use and disclose your PHI to operate this medical practice. For example, we may use and disclose this information to review and improve the quality of care we provide, or the competence and qualifications of our professional staff. We may also use and disclose this information to get your health plan to authorize services or referrals. We may also use and disclose this information as necessary for medical reviews, legal services, and audits, including fraud and abuse detection compliance programs, and business planning and management. We may also share your medical information with our “business associates,” such as a billing service, that performs administrative services for us. We have a written contract with each of these business associates that contains terms requiring them to protect the confidentiality of your medical information.
Appointment Reminders. We may contact you by phone or SMS text as a reminder that you have an upcoming appointment with our office. SMS consent is not shared with third parties. Please notify us in writing at the address listed on the front page of this Notice if you do not wish to be contacted for telephone appointment reminders.
Disclosure to Relatives, Close Friends and Other Caregivers. We may use or disclose your health information to a family member, other relative, a close personal friend, or any other person identified by you when you are present for, or otherwise available prior to the disclosure, if we: 1. Obtain your verbal agreement to do so; 2. Provide you with the opportunity to object to the disclosure and you do not raise an objection; 3. Based on our professional judgment that you would not object to the disclosure. If you are not present, or the opportunity to agree or object to a use or disclosure cannot practicably be provided because of your incapacity or an emergency circumstance, we may exercise our professional judgment to determine whether a disclosure is in your best interests. In the event of an emergency, we may disclose information to public service organizations to facilitate your care. We may disclose your PHI even though you object if we believe it is necessary to respond to emergency circumstances. lf we do disclose information to any of the people listed above, we would disclose only information that we believe is directly relevant to the person's involvement with your health care or payment related to your health care. We may also disclose your PHI in order to notify (or assist in notifying) such persons of your location, general condition, or death.
HIPAA-Compliant Software. Our electronic medical record and software used for video conferencing (also called “telemedicine,” “telepsychiatry, “ or “telehealth”) are digitally secured and HIPAA-compliant. No recordings are made of telemedicine visits.
OTHER PERMITTED OR REQUIRED USES AND DISCLOSURES OF HEALTH INFORMATION
Public Safety. We may, and are sometimes required by law to disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury, or disability; reporting child, elder, or dependent adult abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problems with products and reactions to medications, and reporting disease or infection exposure. When we report suspected elder or dependent adult abuse or domestic violence, we will inform you or your personal representative promptly unless in our best professional judgment we believe the notification would place you at risk of serious harm or would require informing a personal representative we believe is responsible for the abuse or harm.
Lawsuits and Disputes. lf you are involved in a lawsuit or dispute, we may disclose health information about you in response to a court or administrative order. Subject to all applicable legal requirements, we may also disclose health information about you in response to a subpoena.
Law Enforcement Officials. We may disclose your health information to the police or other law enforcement officials as required or permitted by law or in compliance with a court order, Grand Jury, or administrative subpoena.
Health or Safety. We may use or disclose your health information to prevent or lessen a serious and imminent threat to a person or the public's health and safety.
Specialized Government Functions. We may use and disclose your health information for military or national security purposes or to correctional institutions or law enforcement officers that have you in their lawful custody.
Workers’ Compensation. We may disclose your health information as necessary to comply with workers’ compensation laws.
Information Not Personally Identifiable. We may use or disclose health information about you in a way that does not personally identify you or reveal who you are.
Minors. If you are an unemancipated minor under Oregon law, there may be circumstances in which we disclose health information about you to a parent, guardian, or other person acting in loco parentis (“in place of the parent”), in accordance with our legal and ethical responsibilities. Minors 14 years and older may independently consent for outpatient mental health treatment. For additional information see “Minor Rights: Access and Consent to Health Care “ by the Oregon Department of Health at http://public.health.oregon.gov/HealthPeopleFamilies/Youth/Documents/MinorConsent.pdf.
Change of Ownership. In the event that this medical practice is sold or merged with another organization, your health information/record will become the property of the new owner, but you will maintain the right to request that copies of your health information be transferred to another physician or medical group.
As required by law. We may use and disclose your PHI when required to do so by federal, state, or local law.
USE AND DISCLOSURES REQUIRING YOUR WRITTEN AUTHORIZATION
For any purpose other than the ones described above, we may only use or disclose your health information when you give us your written authorization. You may revoke your authorization in writing at any time. However, information previously released cannot be un-released.
Private Payers. We must obtain your authorization to disclose health information to your HMO, health insurer, or other private payer. This authorization is contained within the Billing Agreement.
Uses and Disclosures of Your Highly Confidential lnformation. ln addition, Federal and Oregon law requires special privacy protections for "Highly Confidential lnformation" which includes: 1. Psychotherapy Notes, 2. Mental Health and Developmental Disabilities Services, 3. Alcohol and Drug Abuse Prevention and Treatment Program Services, 4. HIV/AIDS Testing, 5. Sexually
Transmitted Diseases, 6. Child Abuse and Neglect, 7. Sexual Assault, and 8. Genetic Testing. We use and disclose "Highly Confidential lnformation" with your knowledge and limited by a particular purpose.
YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
Right to Request Additional Restrictions. You may request restrictions on our use and disclosure of your health information, such as: 1. For treatment, payment and health care operations; 2. To individuals (such as a family member, or other relative, close personal friend or any other person identified by you) involved with your care or with payment related to your care; or 3. To notify or assist in the notification of such individuals regarding your location and general condition. While we will consider all requests for additional restrictions carefully, we are not required to agree to a requested restriction. lf you wish to request additional restrictions, please submit your request in writing. We will send you a written response.
Right to Receive Confidential Communications. You may request, and we will accommodate any reasonable written request for you to receive your health information by alternative means of communication or at alternative locations.
Right to Revoke Your Authorization. You may revoke your authorization, except to the extent that we have taken action in reliance on it, by delivering a written, signed revocation statement to the address listed at the beginning of this Notice.
Right to lnspect and Copy Your Health lnformation. You have the right to inspect and copy your health information. Under limited circumstances, we may deny your request. For example, we will deny your request to access your child’s records if we believe allowing access would be reasonably likely to cause substantial harm to your child. lf you desire access to your records, please submit a written request detailing what information you want access to and whether you want to inspect it or get a copy of it. lf you request copies, we will charge you a reasonable fee for each page. We will also charge you for our postage costs if you request that we mail the copies to you.
Right to Amend Your Records. You have a right to request that we amend your health information if you believe it is incorrect or incomplete. You must make a request to amend in writing and include the reasons you believe the information is inaccurate or incomplete. We are not required by law to change your health information and in this situation we will provide you with information about our denial and how you can disagree with the denial. We may deny your request if we do not have the information, if we did not create the information, if you would not be permitted to inspect or copy the information at issue, or if we believe the information is accurate and complete as is. You also have the right to request that we add to your record a statement of up to 250 words concerning any item you believe to be incomplete or incorrect.
Right to Receive an Accounting of Disclosures. You have the right to request an "Accounting of Disclosures." This is a list of the disclosures we made of medical information about you for purposes other than treatment, payment, healthcare operations, and a limited number of special circumstances involving national security, correctional institutions, and law enforcement. The list will also exclude any disclosures we have made based on your written authorization. To obtain this list, you must make a request in writing to our office. lt must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in which form you want the list (on paper, electronically, etc.). The first list you request within a 12-month period will be free. For additional lists, we may charge you for the cost of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at the time before any costs are incurred. We will charge you a reasonable fee for each page of the accounting statement.
Right to Receive Paper Copy of This Notice. Upon request, you may obtain a paper copy of this Notice.
For Further lnformation or Complaints. lf you desire further information about your privacy rights, are concerned that we have violated your privacy rights, or disagree with a decision that we made about access to your health information, you may contact the designated Privacy Officer, Kelly Henry, PMHNP. All complaints must be submitted in writing. You may also file written complaints with the Director at the Office for Civil Rights of the U.S. Department of Health and Human Services. Upon request, the Privacy Officer will provide you with the correct address for the Director. We will not retaliate against you if you file a complaint with us or the Director.
Right to Change Terms of This Notice. We may change the terms of this Notice at any time. lf we change this Notice, we may make the new Notice terms effective for all Protected Health lnformation that we maintain, including any information created or received prior to issuing the new Notice. lf we change this Notice, we will post an announcement of the change in our office with information on how to obtain the new Notice. You may also obtain any new Notice by contacting Oasis Mental Health, PC at the address listed on the first page of this Notice.
SMS Terms of Service. By opting into SMS from a web form or other medium, you are agreeing to receive SMS messages from Oasis Mental Health, PC. This includes SMS messages for conversations (external). Message frequency varies. Message and data rates may apply. See privacy policy at [http://www.oasismh.com/privacy.html]. Message HELP for help. Reply STOP to any message to opt out.