How your medical information may be used and shared, and how you can get access to it.
Effective date: October 19, 2026. This notice replaces all earlier versions. · Affordable Psych is a DBA of ATP Mental Health, PLLC
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.
Tyler Patten, APRN, PMHNP-BC
ATP Mental Health, PLLC DBA Affordable Psych
PO Box 869, Huntington, UT 84528
Phone (435) 625-3098 · Fax (435) 355-3878 · tyler@affordablepsych.org
Affordable Psych is a telehealth psychiatry practice. Your mental health information is among the most personal information you can share, and we take protecting it seriously. “Protected health information” (PHI) is information that identifies you and relates to your past, present, or future physical or mental health, the care you receive, or payment for that care.
We are required by law to:
Treatment. We use and share your information to provide and coordinate your care. For example, we send prescriptions to your pharmacy, order tests through laboratories, and may communicate with your other treating providers, such as your primary care provider or therapist.
Payment. Affordable Psych is a self-pay practice and does not bill health insurance. We use your information to process payment for your care, and to prepare a superbill if you request one for your own reimbursement. Because you pay for your care yourself, we will not share information with your health plan unless you ask us to or the law requires it.
Health care operations. We use your information to run the practice, improve the quality of care, meet licensing requirements, and contact you about appointments.
Business associates. We work with companies that help us operate, such as our electronic health record, patient portal, telehealth, secure messaging, payment processing, and documentation services. Each is bound by a written Business Associate Agreement to protect your information.
Appointment reminders. We may contact you by phone, text, email, or patient portal message to remind you of appointments or follow up on your care.
People involved in your care. With your agreement, or if you are given a chance to object and do not, we may share information with a family member, friend, or other person you identify who is involved in your care. In an emergency, or if you are unable to agree, we may share information if we believe it is in your best interest.
We may use or share your information without your authorization in the following situations, only as permitted or required by law:
We will ask for your written authorization before we:
You may revoke an authorization at any time in writing, except to the extent we have already acted on it. We do not use your information for fundraising or for research.
If we receive records about you from a federally assisted substance use disorder treatment program, those records are protected by federal law (42 CFR Part 2) in addition to HIPAA. They will not be used or shared in any civil, criminal, administrative, or legislative proceeding against you without your written consent or a court order that meets federal requirements.
The states where we provide care (Utah, Idaho, and Nevada) may give additional protection to mental health information. When state law is more protective of your privacy than HIPAA, we follow state law.
Get a copy of your records. You may request to see or get a copy of your medical record, in paper or electronic form. Many records are available at no charge in the patient portal. Other requests are generally fulfilled within 30 days, and we may charge a reasonable, cost-based fee.
Ask us to correct your records. You may ask us to amend information you believe is incorrect or incomplete. If we deny your request, we will tell you why in writing, and you may submit a statement of disagreement.
Request confidential communications. You may ask us to contact you in a specific way (for example, only by phone, or only through the patient portal) or at a specific address. We will accommodate reasonable requests.
Ask us to limit what we use or share. You may ask us not to use or share certain information for treatment, payment, or operations. We are not required to agree, except that we must agree to a request not to share information with your health plan for services you paid for in full yourself.
Get a list of disclosures. You may request a list of the times we shared your information in the six years before your request, other than for treatment, payment, operations, and certain other disclosures. One list per year is free.
Choose someone to act for you. If you have given someone medical power of attorney, or someone is your legal guardian, that person can exercise your rights and make choices about your information.
Get a copy of this notice. You may ask for a paper or electronic copy of this notice at any time, even if you agreed to receive it electronically.
Send requests. Submit requests about your information in writing to the Privacy Officer listed at the top of this notice.
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer using the contact information at the top of this notice. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue S.W., Washington, D.C. 20201, by calling 1-877-696-6775, or online at www.hhs.gov/ocr/complaints. We will not retaliate against you for filing a complaint.
We may change this notice, and the changes will apply to all information we have about you. The current notice will be available on request, in the patient portal, and on our website, and we will provide it to you at your next visit after any material change.
See also our Privacy Policy, which covers our website and general business practices.