Effective Date: 07/27/2026
This Notice of Privacy Practices describes how Eleanor Gustke, PMHNP-BC may use and disclose your protected health information (PHI) and explains your rights regarding your health information.
Please review this notice carefully.
Protected health information (PHI) includes information about your health, treatment, and healthcare services that identifies you.
Eleanor Gustke, PMHNP-BC is committed to protecting the privacy and security of your health information and follows applicable federal and state privacy laws, including the Health Insurance Portability and Accountability Act (HIPAA).
Your health information may be used or disclosed for the following purposes:
Information may be used to provide psychiatric evaluation, medication management, coordinate care, and communicate with other healthcare providers involved in your treatment.
Information may be used to bill for services, process payments, verify insurance benefits, and complete other activities related to payment for healthcare services.
Information may be used for activities necessary to operate the practice, including quality improvement, compliance, record management, and practice administration.
With appropriate authorization or when otherwise permitted by law, information may be shared with primary care providers, therapists, specialists, pharmacies, or other healthcare professionals involved in your care.
Your health information may also be disclosed when required or permitted by law, including:
To prevent or reduce a serious threat to your health or safety or the health or safety of others.
When required for reporting suspected child abuse, elder abuse, or dependent adult abuse.
In response to valid legal requests, court orders, or other legal processes.
For public health activities as required by law.
For other purposes required or permitted by applicable law.
You have the right to:
You may request access to your medical records as permitted by law.
You may request corrections or amendments to your health information if you believe information is incorrect or incomplete.
You may request that we communicate with you through specific methods or locations when appropriate.
You may request restrictions on certain uses or disclosures of your health information. While requests will be considered, we are not required to agree to all requested restrictions.
You may request a copy of this Notice of Privacy Practices at any time.
Certain uses or disclosures of your health information may require your written authorization.
You may revoke an authorization in writing at any time, except to the extent that action has already been taken based on that authorization.
Electronic communication, including email and text messaging, may be used for administrative purposes such as scheduling when appropriate.
Because email and text messages may not be secure methods of communication, sensitive health information should be communicated through secure patient communication methods.
Telehealth services involve electronic communication technology.
While reasonable measures are used to protect privacy and security, telehealth has limitations, including potential technology failures or privacy risks related to internet-based communication.
HIPAA-compliant technology, including AI-assisted documentation tools, may be used to support clinical documentation.
These tools assist with documentation only and do not make independent clinical decisions. Clinical notes are reviewed and approved by Eleanor Gustke, PMHNP-BC before becoming part of the medical record.
If you believe your privacy rights have been violated, you may submit a complaint to:
Eleanor Gustke, PMHNP-BC
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.
You will not be penalized or retaliated against for filing a privacy complaint.
Eleanor Gustke, PMHNP-BC reserves the right to update this Notice of Privacy Practices. The most current version will be made available upon request.