NOTICE OF PRIVACY PRACTICES & PRIVACY POLICY

— Haus of Sovereign

HAUS OF SOVEREIGN NOTICE OF PRIVACY PRACTICES

Effective Date: September 25, 2026

YOUR INFORMATION. YOUR RIGHTS. OUR RESPONSIBILITIES.
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.

This Notice applies to protected health information created or maintained in connection with clinical healthcare services provided through Haus of Sovereign.

YOUR RIGHTS
When it comes to your health information, you have certain rights.

ACCESS YOUR HEALTH INFORMATION
You may request to see or receive an electronic or paper copy of your clinical record and other health information we maintain about you. We will respond to your request within the time required by law. A reasonable, cost-based fee may apply where permitted by law.

REQUEST A CORRECTION
If you believe information in your clinical record is incorrect or incomplete, you may ask us to amend it. We may deny certain requests when permitted by law. If we deny your request, we will provide an explanation in writing.

REQUEST CONFIDENTIAL COMMUNICATION 
You may ask us to communicate with you in a particular way or at a particular location.
We will accommodate reasonable requests as required by law.

REQUEST RESTRICTIONS
You may ask us not to use or disclose certain health information for treatment, payment, or healthcare operations.We are not required to agree to every requested restriction. If you pay for a healthcare service in full out of pocket, you may request that information about that service not be disclosed to your health plan for payment or healthcare operations. We will honor that request when required by law.

RECIEVE AN ACCOUNTING OF DISCLOSURES
You may request a list of certain disclosures of your protected health information made during the six years preceding your request. The accounting will not include certain disclosures excluded by law, including many disclosures made for treatment, payment, or healthcare operations. One accounting within a 12-month period will be provided without charge. A reasonable, cost-based fee may apply to additional requests when permitted by law.

RECIEVE A COPY OF THIS NOTICE
You may request a paper copy of this Notice at any time, even if you received or accessed it electronically.

CHOOSE SOMEONE TO ACT FOR YOU
If another person has legal authority to act on your behalf, such as through a healthcare power of attorney or legal guardianship, that person may exercise applicable privacy rights on your behalf. We may verify that person's authority before taking action.

FILE A PRIVACY COMPLAINT
You may file a complaint with Haus of Sovereign if you believe your privacy rights have been violated. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. Haus of Sovereign will not retaliate against you for exercising your privacy rights or filing a complaint.

YOUR CHOICES
For certain health information, you may tell us your preferences regarding how information is shared.
When applicable, you may tell us whether you want us to share information with:
• Family members, close friends, or others involved in your care or payment for your care
• Others involved in responding to an emergency or disaster-relief situation
If you are unable to communicate your preference, we may disclose information when permitted by law and when we determine that doing so is in your best interest or is necessary to address a serious and imminent threat to health or safety.

WRITTEN AUTHORIZATION
We will obtain your written authorization when required by law. We will not use or disclose your protected health information for marketing purposes, sell your protected health information, or disclose most psychotherapy notes without your written authorization when authorization is required by law. If you provide written authorization, you may revoke that authorization in writing, subject to applicable law and actions already taken in reliance upon it.

HOW WE MAY USE + DISCLOSE YOUR INFORMATION
Federal law permits us to use o disclose protected health information in certain circumstances without obtaining separate authorization from you.

TREATMENT
We may use your health information and share it with healthcare professionals involved in providing or coordinating your treatment. This may include appropriate clinical consultation, supervision, treatment-team collaboration, and coordination of care.

PAYMENT
We may use or disclose health information as necessary to bill for services, receive payment, process transactions, manage balances, or perform other payment activities permitted by law.

HEALTHCARE OPERATIONS
We may use or disclose health information as necessary to operate the clinical practice, improve the quality of services, maintain professional and regulatory compliance, conduct appropriate supervision, and perform other healthcare operations permitted by law.

PUBLIC HEALTH + SAFETY
When permitted or required by law, we may disclose health information for certain public-health and safety purposes, including:
• Reporting suspected abuse or neglect when required by law
• Preventing or reducing a serious threat to health or safety
• Other legally authorized public-health activities

COMPLIANCE WITH THE LAW
We may disclose information when state or federal law requires us to do so, including disclosures to government agencies responsible for overseeing compliance with healthcare and privacy laws
.
HEALTH OVERSIGHT + GOVERNMENT FUNCTIONS
Information may be disclosed to authorized health-oversight agencies, law-enforcement officials, or government entities when permitted or required by law.

LEGAL PROCCEDINGS
We may disclose information in response to certain court or administrative orders, subpoenas, or other lawful processes when disclosure is permitted or required by law.

RESEARCH
Health information may be used or disclosed for research when the requirements and protections established by law have been satisfied.

OTHER LEGALLY PERMITTED DISCLOSURES
Federal law permits certain additional uses and disclosures, including those related to workers' compensation, medical examiners or funeral directors, organ and tissue donation, and other purposes authorized by law.

SUBSTANCE USE DISORDER RECORDS
Certain substance use disorder records may receive additional protections under federal law, including 42 CFR Part 2. To the extent Haus of Sovereign creates or maintains records protected by Part 2, those records will be used and disclosed in accordance with applicable federal requirements. Part 2-protected records generally may not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you without your written consent or a qualifying court order and subpoena, as required by law.

OUR RESPONSIBILITIES
Haus of Sovereign is required by law to:
• Maintain the privacy and security of your protected health information
• Provide you with notice of our legal duties and privacy practices
• Follow the duties and privacy practices described in the Notice currently in effect
• Notify you as required by law if a breach occurs that may have compromised the privacy or security of your information
• Provide you with a copy of this Notice upon request
We will not use or disclose your protected health information other than as described in this Notice unless you authorize us to do so in writing or the use or disclosure is otherwise permitted or required by law.

CHANGES TO THIS NOTICE
Haus of Sovereign may change the terms of this Notice and may make revised terms applicable to protected health information already maintained by the practice as permitted by law. If this Notice is materially revised, the current version will be made available on the Haus of Sovereign website, at the practice, and upon request.

QUESTIONS + PRIVACY COMPLAINTS
If you have questions about this Notice, would like to exercise your privacy rights, or believe your privacy rights have been violated, please contact:

Haus of Sovereign Privacy Officer
Brenna O’Brien, LCSW
Phone: 615-212-9797
Email: remember@haus-sovereign.com

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. Haus of Sovereign will not retaliate against you for filing a complaint or exercising your privacy rights.