NOTICE OF PRIVACY PRACTICES
Heffron Health & Wellness LLC | Luna Eclipsed Psychiatry
Effective Date: October 1, 2026
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
Heffron Health & Wellness LLC is required by law to maintain the privacy and security of your protected health information (“PHI”), provide you with this Notice describing our legal duties and privacy practices, and follow the terms of the Notice currently in effect.
We will notify you following a breach of your unsecured protected health information when notification is required by law.
We will not use or disclose your protected health information except as described in this Notice or as otherwise permitted or required by law.
HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
We may use and disclose your protected health information for treatment, payment, and healthcare operations as permitted by law.
Treatment: We may use or share your health information with healthcare professionals involved in your care for purposes such as evaluation, treatment, medication management, care coordination, referrals, and consultation.
Payment: We may use or disclose information as necessary to bill and obtain payment for services, determine eligibility or coverage, obtain authorization when applicable, and coordinate benefits.
Healthcare Operations: We may use or disclose information for activities necessary to operate the practice, including quality assessment, compliance activities, credentialing, auditing, business administration, training, and other healthcare operations permitted by law.
OTHER PERMITTED OR REQUIRED USES AND DISCLOSURES
We may use or disclose your protected health information without your written authorization when permitted or required by law. Examples may include:
Required by Law: We may disclose information when federal, state, or local law requires us to do so.
Public Health and Safety: We may disclose information for certain public health activities or when necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public, as permitted by law.
Abuse, Neglect, or Domestic Violence: We may report information to appropriate authorities when required or permitted by applicable law.
Health Oversight: We may disclose information to authorized health oversight agencies for activities such as audits, investigations, inspections, licensure, and other legally authorized oversight activities.
Legal and Administrative Proceedings: We may disclose information in response to certain court or administrative orders, subpoenas, discovery requests, or other lawful processes when the requirements for disclosure have been satisfied.
Law Enforcement: We may disclose information to law enforcement when specifically permitted or required by law.
Workers' Compensation: We may disclose information as authorized by and necessary to comply with workers' compensation or similar programs.
Coroners, Medical Examiners, and Funeral Directors: We may disclose information as permitted by law for purposes related to identifying a deceased person, determining cause of death, or carrying out authorized duties.
Research: We may use or disclose information for research when the applicable legal requirements and required privacy protections have been satisfied.
Business Associates: We may disclose protected health information to individuals or organizations that perform services on our behalf when permitted by law and when appropriate privacy and security safeguards are in place.
USES AND DISCLOSURES REQUIRING YOUR WRITTEN AUTHORIZATION
For uses and disclosures of protected health information not otherwise permitted or required by law, we will obtain your written authorization. You may revoke an authorization in writing at any time, except to the extent that we have already acted in reliance on it.
Psychotherapy Notes: Most uses and disclosures of psychotherapy notes require your written authorization. Psychotherapy notes receive additional protection under federal law and are maintained separately from the rest of the medical record when applicable. Certain limited exceptions permitted by law may apply.
Marketing: We will obtain your written authorization before using or disclosing protected health information for marketing purposes when authorization is required by law.
Sale of Protected Health Information: We will obtain your written authorization before any disclosure that constitutes a sale of protected health information when authorization is required by law.
Other Uses and Disclosures: Other uses and disclosures not described in this Notice will be made only with your written authorization unless otherwise permitted or required by law.
YOUR PRIVACY RIGHTS
You have certain rights regarding your health information. These rights include:
Access Your Health Information: You may ask to inspect or obtain an electronic or paper copy of your medical record and other health information maintained about you. We generally will provide access or a copy within 30 days of your request, as required by law. A reasonable, cost-based fee may apply.
Request an Amendment: If you believe health information in your record is incorrect or incomplete, you may ask us to amend it. We may deny your request in certain circumstances permitted by law. If we deny the request, we will provide you with a written explanation.
Request Confidential Communications: You may ask us to communicate with you in a particular way or at a particular location, such as contacting you only at a specific telephone number or address. We will accommodate reasonable requests.
Request Restrictions: You may ask us to limit certain uses or disclosures of your health information for treatment, payment, or healthcare operations. We are generally not required to agree to your request. However, when you pay in full out-of-pocket for a healthcare service or item, you may request that information about that service or item not be disclosed to your health plan for payment or healthcare operations, unless disclosure is required by law.
Receive an Accounting of Disclosures: You may request a list of certain disclosures of your health information made during the six years before your request. The accounting will not include certain disclosures excluded by law, including many disclosures for treatment, payment, or healthcare operations. We will provide one accounting in a 12-month period without charge. A reasonable, cost-based fee may apply to additional requests during that period.
Receive a Copy of This Notice: You may request a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.
Choose Someone to Act for You: If another person has legal authority to act on your behalf, such as a legal guardian or an individual holding an applicable healthcare power of attorney, that person may exercise your privacy rights as permitted by law. We will verify that authority before taking action.
File a Complaint: You may file a complaint with Heffron Health & Wellness LLC 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. We will not retaliate against you for filing a complaint.
YOUR CHOICES
For certain health information, you may tell us your preferences about what we share. If you have a clear preference about how we share your information in the situations described below, tell us what you want us to do and we will follow your instructions when required by law.
Family, Friends, and Others Involved in Your Care: You may tell us whether we may share relevant health information with family members, close friends, or others involved in your care or payment for your care. If you are unable to tell us your preference, such as during an emergency, we may share information when permitted by law and when we determine that doing so is in your best interest.
Disaster Relief: We may share limited information with an authorized disaster relief organization when permitted by law to assist with notification or coordination of care.
Fundraising: If the practice conducts fundraising activities using information permitted by law, you have the right to tell us not to contact you again for fundraising purposes.
SUBSTANCE USE DISORDER RECORDS
Certain substance use disorder (“SUD”) patient records may receive additional confidentiality protections under federal law, including 42 CFR Part 2.
To the extent that Heffron Health & Wellness LLC creates, maintains, receives, or holds records that are subject to 42 CFR Part 2, those records will be used and disclosed only as permitted by applicable law.
Treatment, Payment, and Healthcare Operations: When permitted by law and with the appropriate patient consent, Part 2 records may be used or disclosed for treatment, payment, and healthcare operations. A patient may provide a single consent for future treatment, payment, and healthcare operations uses and disclosures as permitted under Part 2.
Legal Proceedings and Investigations: Part 2 records generally may not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against a patient without the patient's written consent or a court order and subpoena or other legal mandate that satisfies applicable Part 2 requirements.
Redisclosure: When Part 2 records are disclosed pursuant to a valid consent for treatment, payment, and healthcare operations to a recipient subject to HIPAA, the recipient may redisclose the information as permitted by HIPAA, subject to applicable Part 2 limitations. Part 2 information remains protected against use in legal proceedings against the patient except as permitted by law.
Fundraising: If Part 2 information would be used for fundraising communications, you will receive clear notice in advance and an opportunity to elect not to receive such communications, as required by law.
Complaints: You may file a complaint regarding the privacy or security of Part 2 records with the practice or with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.
CHANGES TO THIS NOTICE
We reserve the right to change this Notice and our privacy practices. Any revised Notice may apply to protected health information we already maintain as well as information we receive in the future. The current Notice will be available upon request and posted on our website.
QUESTIONS, PRIVACY REQUESTS, AND COMPLAINTS
If you have questions about this Notice, wish to exercise your privacy rights, request access to or amendment of your health information, request an accounting of disclosures, or file a privacy complaint, please contact:
Privacy Officer
Heffron Health & Wellness LLC
Luna Eclipsed Psychiatry
Email:kheffron@heffronhealthwellness.com
Phone:623-242-3970
Mailing Address:6751 N. Sunset Blvd Ste. 320 Glendale, Az 85305
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. Information about filing a complaint is available through the HHS Office for Civil Rights.
We will not retaliate against you or deny treatment because you exercised a privacy right or filed a complaint.
EFFECTIVE DATE
This Notice is effective October 1, 2026.