This Notice of Privacy Practices describes how Evermore Wellness, LLC may use and disclose your Protected Health Information (“PHI”) and how you can access this information. We are committed to protecting your privacy in accordance with the Health Insurance Portability and Accountability Act (“HIPAA”), its Privacy and Security Rules, and applicable professional ethics.

State Law Reference: This Notice also complies with New Jersey state laws governing confidentiality of mental health records. When New Jersey law provides stronger privacy protections than HIPAA, the New Jersey law will apply, for example, in specific rules about releasing a minor’s records.

We are required by law to maintain the confidentiality of your PHI and to provide this notice explaining our legal duties and privacy practices. We reserve the right to change this notice at any time. Updates will be available on our website, by mail upon request, or at your next appointment.

HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION

For Treatment: Your PHI may be used and shared to coordinate your care and treatment. This includes consultation with supervisors or professional colleagues. We will not disclose PHI to anyone outside your care team without your written authorization.

For Payment: We may use or disclose your PHI to process payments, verify insurance, or complete billing. If outside collection becomes necessary, only the minimum required information will be shared.

For Health Care Operations: We may use PHI for administrative functions such as quality improvement, licensing, or professional supervision. Third-party vendors who assist with business operations must sign agreements ensuring they safeguard your information.

Required by Law: We must disclose PHI to you upon request and to the Department of Health and Human Services for compliance purposes.

USES AND DISCLOSURES WITHOUT YOUR AUTHORIZATION

We may use or disclose PHI without your written authorization in certain cases, including:
• Reporting child abuse or neglect. 
• Responding to valid court orders or legal investigations. 
• Addressing emergencies where disclosure prevents serious harm. 
• Cooperating with health oversight agencies (audits, inspections, or investigations). 
• Complying with law enforcement requests or public health reporting obligations. 
• When necessary to prevent a serious and imminent threat to health or safety. 

Any other use or disclosure will require your explicit written authorization, which you may revoke in writing at any time.

PSYCHOTHERAPY NOTES

Psychotherapy Notes, as defined by HIPAA, receive special protection and are maintained separately from your general clinical record. These notes are not used or disclosed for treatment, payment, or health care operations without your written authorization, except where otherwise required by law.

YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

You have the right to:
• Inspect and request a copy of your health and billing records (electronically or       paper). 
• Request an amendment if you believe information is incomplete or inaccurate. 
• Request a list of certain disclosures we have made. 
• Request limits on sharing of your PHI, including restrictions on sharing with your   health plan if you paid out of pocket. 
• Request confidential communications by specific means or locations. 
• Receive notice if a breach of unsecured PHI occurs. 
• Request and receive a copy of this notice at any time. 

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with:  
Evermore Wellness, LLC 
24 North 3rd Ave, Suite 109, Highland Park, NJ 08904 
Phone: 732-672-6564 | Email: evermorewellness@hushail.com 

Or contact the Secretary of Health and Human Services. We will provide you with the contact information upon your request.

There will be no retaliation for filing a complaint.

Effective Date: October 2025