Notice of Privacy Practices
Root & Restore Wellbeing
NOTICE OF PRIVACY PRACTICES
Effective Date: September 5, 2026
Your Information. Your Rights. Our Responsibilities.
This notice describes how medical and mental health information about you may be used and disclosed and how you can obtain access to that information. Please review it carefully.
Root & Restore Wellbeing LLC (“Root & Restore Wellbeing,” “we,” “us,” or “our”) is committed to protecting the privacy of your health information and complying with applicable federal and state privacy laws.
YOUR RIGHTS
When it comes to your health information, you have certain rights.
Get a copy of your health information
You have the right to inspect and obtain a copy of health information about you that is maintained by Root & Restore Wellbeing and that you have a legal right to access. You may request your records in paper or electronic form.
Certain information may be excluded from access when permitted or required by applicable law. This includes psychotherapy notes maintained separately from the clinical record and certain information that may be withheld under applicable federal or state law.
Ask us to correct your health information
You may ask us to correct health information about you that you believe is incorrect or incomplete. We may deny your request in certain circumstances permitted by law, but we will provide you with a written explanation if we do so.
Request confidential communications
You may ask us to communicate with you about your care in a particular way or at a particular location. For example, you may ask us to contact you only by email or at an alternate mailing address.
We will accommodate reasonable requests when permitted by law.
Ask us to limit what we use or disclose
You may ask us to limit the health information we use or disclose for treatment, payment, or health care operations.
We are not required to agree to every request, except where applicable law requires us to do so. If you pay for a service or health care item completely out of pocket and request that we not disclose that information to your health plan for payment or health care operations purposes, we will generally agree unless disclosure is required by law.
Get a list of certain disclosures
You may request an accounting of certain disclosures of your health information made by Root & Restore Wellbeing, as permitted by applicable law.
Get a copy of this notice
You may request a paper or electronic copy of this Notice of Privacy Practices at any time.
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 when legally authorized to do so.
File a complaint
You may file a complaint if you believe your privacy rights have been violated. You may contact Root & Restore Wellbeing or the U.S. Department of Health and Human Services Office for Civil Rights.
You will not be retaliated against for filing a complaint.
YOUR CHOICES
For certain health information, you may have choices about what we disclose.
People involved in your care
You may ask us to share information with a family member, close friend, or another person involved in your care or payment for your care when permitted by law.
You may also ask us not to share this information.
Communications
You may ask us to contact you in a particular way or at a particular location.
Marketing and sale of information
We will not use or disclose your health information for marketing purposes or sell your health information without your written authorization when authorization is required by law.
SHARING INFORMATION WITH OTHER HEALTH CARE PROVIDERS
Root & Restore Wellbeing may disclose mental health information to another health care provider when permitted by applicable law and when the disclosure is necessary to facilitate your care or another permitted health care activity.
For clients receiving services in or under the laws of the District of Columbia: D.C. law provides specific authority for certain disclosures of mental health information to another health care provider for purposes such as diagnosis, evaluation, treatment, case management, quality assessment and improvement, or rehabilitation when necessary to facilitate professional services. This authority does not include disclosure of progress notes.
Upon registration, D.C. law requires that clients be notified in plain language about these disclosures and their right to request that their information not be disclosed under this provision.
You may request that your mental health information not be disclosed to another health care provider under circumstances where applicable law permits you to object or request a restriction. We will consider and honor such requests as required by applicable law.
HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
We may use or disclose your health information without your written authorization when permitted or required by applicable law.
Treatment
We may use and disclose your health information to provide, coordinate, or manage your care.
For example, we may communicate with another health care provider involved in your treatment when permitted by law.
Payment
We may use and disclose your health information to bill and receive payment for services.
For example, we may provide necessary information to your health insurance plan to obtain payment for services.
Health Care Operations
We may use and disclose your health information for activities necessary to operate our practice and provide quality care.
Examples may include quality assessment, administrative activities, credentialing, compliance, and business management.
Required by Law
We may use or disclose your health information when required by federal, state, or local law.
Public Health
We may disclose health information for certain public health activities permitted or required by law.
Serious Threats to Health or Safety
We may use or disclose information when necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public, when permitted by law.
Judicial and Administrative Proceedings
We may disclose health information in response to certain court or administrative proceedings when permitted or required by law.
Law Enforcement
We may disclose health information for certain law enforcement purposes when permitted or required by law.
Health Oversight
We may disclose health information to appropriate government agencies for activities authorized by law, including audits, investigations, inspections, and licensing activities.Workers' Compensation
We may disclose health information as authorized by or required for workers' compensation programs.
Specialized Government Functions
We may disclose health information for certain specialized government functions when authorized or required by law.
Medical Examiners, Coroners, and Funeral Directors
We may disclose health information to medical examiners, coroners, and funeral directors when permitted or required by law.
Research
We may use or disclose health information for research purposes when permitted by applicable law and appropriate privacy protections are in place.
USES AND DISCLOSURES REQUIRING YOUR AUTHORIZATION
Other uses and disclosures of your health information that are not described in this notice or otherwise permitted or required by law will be made only with your written authorization.
If you provide written authorization, you may revoke that authorization in writing at any time, except to the extent Root & Restore Wellbeing has already relied upon it.
Authorization is separate from this Notice of Privacy Practices. Signing this notice does not authorize Root & Restore Wellbeing to use or disclose your health information for purposes that require your separate written authorization.
ADDITIONAL PRIVACY PROTECTIONS
Some health information may receive additional protection under federal or state law.
Substance Use Disorder Records
Root & Restore Wellbeing may provide services to individuals who have concerns related to substance use, recovery, or other behavioral health conditions. The presence of substance use concerns alone does not mean that all records maintained by Root & Restore Wellbeing are subject to the federal confidentiality regulations known as 42 CFR Part 2.
If Root & Restore Wellbeing creates or maintains records that are subject to Part 2, we will comply with the additional privacy and disclosure requirements that apply to those records.
State Privacy Protections
Virginia and the District of Columbia provide additional protections concerning mental health information and health records. Root & Restore Wellbeing will comply with applicable federal and state privacy requirements, including any requirements that provide greater protection or impose greater restrictions on the use or disclosure of your information.
OUR RESPONSIBILITIES
Root & Restore Wellbeing is required by law to:
Maintain the privacy and security of your protected health information.
Provide you with this notice describing our legal duties and privacy practices.
Follow the terms of 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.
Comply with applicable federal and state privacy laws.
We reserve the right to change our privacy practices and this notice. Any changes will apply to health information we maintain, including information created or received before the change.
The current version of this notice will be available upon request and on our website.
QUESTIONS OR COMPLAINTS
If you have questions about this notice or our privacy practices, please contact:
Root & Restore Wellbeing LLC
Privacy Contact: Adriana Scott, LCSW
Email:adriana@rootandrestorewellbeing.com
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.
We will not retaliate against you for filing a complaint.