Notice of Privacy Practices

Effective Date: July 10, 2026

Your information. Your rights. Our responsibilities.

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

This notice applies to psychotherapy and related healthcare services provided by Jose H. Caraballo LCSW LLC.

Your Rights

Obtain a Copy of Your Record

You may ask to inspect or receive an electronic or paper copy of your medical record and other health information maintained by the Practice.

The Practice will generally provide a copy or summary within 30 days and may charge a reasonable, cost-based fee as permitted by law. Access to psychotherapy notes may be limited as allowed by law.

Ask to Correct Your Record

You may ask the Practice to correct health information you believe is inaccurate or incomplete.

The request may be denied in certain circumstances, but you will receive a written explanation, generally within 60 days.

Request Confidential Communications

You may ask the Practice to contact you in a specific way, such as only by phone or at a particular address. Reasonable requests will be accommodated.

Request Limits on Use or Sharing

You may ask the Practice not to use or share certain health information for treatment, payment, or healthcare operations. The Practice is not always required to agree.

If you pay for a service in full out of pocket and ask that information about that service not be shared with your health plan for payment or healthcare operations, the Practice will honor the request unless disclosure is required by law.

Receive a List of Certain Disclosures

You may request a list of certain disclosures of your health information made during the six years before your request.

The first list provided within a 12-month period is free. A reasonable, cost-based fee may apply to additional requests.

Obtain a Copy of This Notice

You may request a paper copy of this notice at any time, even if you agreed to receive it electronically.

Choose Someone to Act for You

If you have given someone medical power of attorney or if someone is your legal guardian, that person may exercise your rights and make choices about your health information as permitted by law.

The Practice will verify that person’s authority before taking action.

File a Complaint

You may file a complaint directly with the Practice using the contact information below.

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by visiting hhs.gov/ocr/privacy/hipaa/complaints or calling 1-877-696-6775.

You will not be retaliated against for filing a complaint.

Your Choices

For certain health information, you may tell the Practice your preferences about sharing.

Unless you object or the law allows otherwise, you may direct whether information is shared with family members, close friends, or others involved in your care or payment for care.

If you are unable to state a preference, information may be shared when the Practice believes it is in your best interest or when necessary to reduce a serious and imminent threat to health or safety.

The Practice will obtain your written authorization before:

• Using or sharing your information for marketing 
• Selling your information 
• Using or sharing most psychotherapy notes, except as otherwise permitted by law 

The Practice does not currently conduct fundraising. If fundraising communications are ever sent, you may opt out.

How the Practice May Use and Share Your Information

Treatment

Health information may be used and shared with other professionals involved in your treatment or care coordination.

Payment

Health information may be used and shared to verify benefits, submit claims, bill for services, and obtain payment from health plans or other responsible parties.

Healthcare Operations

Health information may be used and shared to operate the Practice, improve care, conduct quality reviews, perform administrative functions, and contact you when necessary.

Other Uses and Disclosures

The Practice may use or share health information when permitted or required for purposes including:

• Public-health and safety activities 
• Reporting suspected abuse, neglect, or domestic violence 
• Preventing or reducing a serious threat to health or safety 
• Health oversight activities and licensing reviews 
• Responding to lawful court orders, subpoenas, or administrative proceedings 
• Workers’ compensation matters 
• Law-enforcement purposes permitted by law 
• Coroners, medical examiners, and funeral directors 
• Research when legal requirements have been satisfied 
• Special government functions and national-security activities 
• Compliance with federal and Florida law 

More restrictive federal or Florida confidentiality laws may apply to certain mental-health, substance-use, HIV, or other sensitive information.

Substance-Use-Disorder Records and Legal Proceedings

Records received from a federally assisted substance-use-disorder program and protected by 42 CFR Part 2 may have additional protections.

Such records, or testimony describing their contents, generally may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless you provide written consent or a court order authorizes the use or disclosure as permitted by law.

The Practice’s Responsibilities

The Practice is required to:

• Maintain the privacy and security of protected health information 
• Notify you if a breach may have compromised the privacy or security of your information 
• Follow the duties and privacy practices described in the notice currently in effect 
• Provide this notice and make it available upon request and on the Practice website 
• Obtain written authorization for uses and disclosures not described in this notice, unless otherwise permitted by law 

You may revoke a written authorization at any time by notifying the Practice in writing. This will not affect actions already taken based on the authorization.

Changes to This Notice

The Practice may change this notice and make the revised notice effective for all health information maintained by the Practice.

The current notice will be available upon request and posted at josehcaraballolcsw.com.

Privacy Contact

Jose H. Caraballo LCSW LLC
Privacy Officer: Jose H. Caraballo, LCSW
Fort Lauderdale, Florida
Email: info@josehcaraballolcsw.com
Phone: 786-322-4114