Notice of Privacy Practices

NOTICE OF PRIVACY PRACTICES

Blossomed Lotus LLC
1000 Main St, Suite 2300, Houston, TX 77002 · 320 Boston Post Rd, Suite 180, Darien, CT 06820
Phone: (877) 735-6887 · blossomedlotus.com

Effective date: November 9, 2026

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Our pledge

Blossomed Lotus LLC (“Blossomed Lotus,” “we,” “us”) is required by law to maintain the privacy of your protected health information (PHI), to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect. We will notify you promptly if a breach occurs that may have compromised the privacy or security of your information.

How we may use and disclose your health information

Treatment. We may use and disclose your PHI to provide, coordinate, or manage your care — for example, your therapist’s clinical notes, treatment plans, and consultation with another provider involved in your treatment (including consultation within our practice and with your other treating providers, as permitted by law).

Payment. We may use and disclose your PHI to bill and collect payment — for example, submitting claims to your health plan, verifying coverage and eligibility, and processing your card on file for balances you owe.

Health care operations. We may use and disclose your PHI for our operations — for example, quality assessment, staff training and supervision, licensing, and business planning.

Appointment reminders and communications. We may contact you about appointments and other matters related to your care by phone, voicemail, text message, email, or patient-portal message, as you have consented to in our Contact & Text Consent form. You may opt out of any of these at any time.

As required by law. We will disclose your PHI when required to do so by federal, state, or local law.

To avert a serious threat to health or safety. We may disclose your PHI when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person, consistent with applicable law and ethical standards.

Abuse, neglect, and domestic violence. As licensed professionals, we are mandated reporters. We may (and in some cases must) report suspected abuse or neglect of a child, an elderly person, or a dependent adult to the appropriate authorities.

Health oversight. We may disclose your PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and licensure of our providers.

Judicial and administrative proceedings. We may disclose your PHI in response to a court or administrative order, or in response to a subpoena or other lawful process as permitted by law. Psychotherapy notes receive special protection and are generally not disclosed without your written authorization except in narrow circumstances defined by law.

Workers’ compensation. We may disclose your PHI as authorized to comply with workers’ compensation laws.

Individuals involved in your care. With your agreement (or, in limited circumstances, an opportunity to object), we may share relevant PHI with a family member or other person you identify as involved in your care or payment for your care.

Uses and disclosures that require your written authorization

Other uses and disclosures of your PHI not covered by this notice — including most uses of psychotherapy notes, and any use for marketing or the sale of your information — will be made only with your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already relied on it.

Your rights

You have the right to:

  • Get a copy of your medical record — in paper or electronic form. We will provide a copy or summary, usually within the time required by law, and may charge a reasonable, cost-based fee.
  • Request a correction to your record if you believe information is incorrect or incomplete. We may say no, but we will tell you why in writing.
  • Request confidential communications — for example, ask us to contact you at a different number or address. We will honor reasonable requests.
  • Ask us to limit what we use or share. We are not required to agree to every request, except that we must agree not to disclose information to your health plan about an item or service you paid for entirely out of pocket, if you ask us not to share it for payment or operations purposes.
  • Get a list (accounting) of disclosures we have made of your PHI for the six years prior to your request, other than disclosures for treatment, payment, operations, or those you authorized.
  • Get a copy of this notice at any time, in paper or electronic form.
  • Have someone act on your behalf if you have given someone medical power of attorney or if someone is your legal guardian.
  • File a complaint with us or with the U.S. Department of Health and Human Services if you believe your privacy rights have been violated. We will not retaliate against you for filing a complaint.

Changes to this notice

We reserve the right to change the terms of this notice and to make the new terms effective for all PHI we maintain. The current version will be posted on our website and available at our offices.

Contact

If you have questions about this notice or wish to exercise your rights, contact our Privacy Officer:

Nathalie Alabre, LPC — Privacy Officer, Blossomed Lotus LLC
(877) 735-6887 · nathalie@blossomedlotus.com
1000 Main St, Suite 2300, Houston, TX 77002