Notice of Privacy Practices

Kaylee Rabaja, LLC

Effective Date: 6/27/25

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 Responsibilities

Kaylee Rabaja, LLC is committed to protecting the privacy of your personal health information. We are required by law to:

● Maintain the privacy of your protected health information (PHI)

● Provide you with this Notice of Privacy Practices

● Abide by the terms of this notice

● Notify you if there is a breach of your unsecured PHI

How We May Use and Disclose Your Health Information

We may use and disclose your PHI without your written authorization in the following ways:

1. For Treatment

We may use your PHI to provide, coordinate, or manage your care. For example, we may share information with your child’s pediatrician or a referring physician if needed for care coordination.

2. For Payment

We may use and share your PHI to bill and receive payment from health plans or other entities. For example, we may need to provide your insurance company with details of your visit to process a claim.

3. For Healthcare Operations

We may use your PHI to operate our practice. This includes internal administration, quality improvement, licensing, and auditing.

4. As Required by Law

We may disclose your PHI when required by federal, state, or local law (e.g., reporting abuse, neglect, or threats of harm).

5. For Public Health and Safety

We may share PHI to help prevent or control disease, injury, or disability, or in emergencies that threaten your health or the public.

Other Uses and Disclosures Require Your Authorization

For any uses or disclosures not described above, we will obtain your written permission (authorization) before using or sharing your PHI. This includes:

● Marketing communications

● Release of psychotherapy notes (if applicable)

● Sale of PHI

You may revoke your authorization in writing at any time.

Your Rights Regarding Your Health Information

You have the following rights concerning your PHI:

✔️ Right to Access

You can request to view or get a copy of your medical record. We may charge a reasonable fee for copies.

✔️ Right to Request Amendments

If you believe your health record is incorrect or incomplete, you may ask us to amend it. ✔️ Right to Request Restrictions

You may request limitations on how we use or disclose your PHI. While we’re not required to agree to your request, we will consider it.

✔️ Right to Confidential Communications

You can request that we contact you in a specific way (e.g., only by phone or mail) or at a specific location.

✔️ Right to an Accounting of Disclosures

You can request a list of certain disclosures we have made of your PHI for reasons other than treatment, payment, or healthcare operations.

✔️ Right to a Copy of This Notice

You can request a paper or digital copy of this Notice at any time.

Our Commitment to Your Privacy

We take your privacy seriously. Your PHI will only be accessed by those who need it for care, operations, or billing purposes, or as required by law.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with:

Kaylee Rabaja, LLC

Email: lactation@kayleerabaja.com

You may also file a complaint with the U.S. Department of Health & Human Services Office for Civil Rights at:

https://www.hhs.gov/hipaa/filing-a-complaint/index.html

You will not be penalized for filing a complaint.

Contact Information

For questions or to exercise your rights, contact:

Privacy Officer