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Privacy Policy

 

Privacy Policy

Effective Date: January 1, 2025 Equilibrium Mental Health Services (“we,” “our,” or “us”) is committed to protecting your privacy. This Privacy Policy explains how we collect, use, disclose, and protect your personal and health information when you use our website and telehealth services.

1. Information We Collect

We may collect the following types of information:
  • Personal Information: Name, email address, phone number, date of birth, address, and insurance details.
  • Health Information: Medical history, diagnosis, treatment plans, medications, and other data protected under the Health Insurance Portability and Accountability Act (HIPAA).
  • Technical Information: IP address, browser type, device identifiers, and usage data when you visit our website.

2. How We Use Your Information

We use your information to:
  • Provide and manage your mental health care
  • Communicate with you about appointments and services
  • Process payments and insurance claims
  • Improve our services and website
  • Comply with legal and regulatory obligations

3. Sharing Your Information

We do not sell or rent your personal information. We may share your information with:
  • Authorized providers involved in your care
  • Health insurance companies and billing services
  • Technology vendors who support our telehealth platform, under strict confidentiality agreements
  • Government or regulatory agencies, if required by law

4. Your Rights Under HIPAA

You have the right to:
  • Access your health records
  • Request corrections to your medical information
  • Receive a list of disclosures we’ve made
  • Request restrictions on certain uses or disclosures
  • File a complaint if you believe your privacy rights have been violated

5. Data Security

We use secure technologies and follow industry best practices to protect your personal and health information from unauthorized access, disclosure, or loss. Our telehealth platform is encrypted and HIPAA-compliant.

6. Cookies and Tracking Technologies

Our website may use cookies to improve user experience and analyze site traffic. You can manage your cookie preferences through your browser settings.

7. Third-Party Links

Our site may contain links to external websites. We are not responsible for the privacy practices or content of third-party sites.

8. Changes to This Policy

We reserve the right to update this Privacy Policy at any time. Updates will be posted on this page with a revised effective date.

9. Contact Us

If you have any questions or concerns about this Privacy Policy, please contact us:

Equilibrium Mental Health Services
Email: Equilibriummhs@gmail.com
Phone: 786-247-1308
Website: equilibriumpsychiatry.com  
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(786) 247-1308

14221 SW 120th St, Suite 221
Miami, FL 33187
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Terms and Disclaimer for Appointment Request Form

Privacy Notice and Consent

By submitting this form, you acknowledge and agree to the following:

Protected Health Information (PHI)

The information you provide may constitute Protected Health Information (PHI) under the Health Insurance Portability and Accountability Act (HIPAA). We are committed to protecting your privacy and maintaining the confidentiality of your health information in accordance with federal and state laws.

Information Collection and Use

  • Information submitted through this form will be used solely for appointment scheduling and initial assessment purposes

  • Your information may be accessed by authorized healthcare providers and administrative staff involved in your care

  • We will not share your information with third parties without your written authorization, except as required by law

Security Measures

  • This form is transmitted through encrypted, HIPAA-compliant technology

  • Your information is stored on secure servers with restricted access

  • We maintain physical, electronic, and procedural safeguards to protect your PHI

Your Rights

You have the right to:

  • Request access to your health information

  • Request amendments to your health information

  • Request restrictions on how your information is used or disclosed

  • File a complaint if you believe your privacy rights have been violated

Consent for Communication

By providing your contact information, you consent to receive appointment-related communications via the methods you specify (phone, email, or text). You may revoke this consent at any time.

 

Important Disclaimers

Emergency Situations

This form is NOT for emergency situations. If you are experiencing a mental health crisis, suicidal thoughts, or any psychiatric emergency, please:

  • Call 911 immediately

  • Go to your nearest emergency room

  • Contact the National Suicide Prevention Lifeline at 988

  • Call your local crisis intervention team

No Provider-Patient Relationship

Submitting this form does not establish a provider-patient relationship. A therapeutic relationship begins only after you have been accepted as a client and have attended your first appointment.

Response Time

While we strive to respond within one business day, this form should not be used for urgent matters requiring immediate attention. For urgent concerns, please call our office directly.

Technical Limitations

Although we use secure technology, no method of electronic transmission is 100% secure. By using this form, you acknowledge this inherent risk.

Age Requirements

If you are under 18 years of age, a parent or legal guardian must provide consent before we can schedule your appointment.

Contact Information

For questions about this privacy notice or to exercise your rights, please contact:
Office Phone: +1 (786) 247-1308
Email: equilibriummhs@gmail.com

By clicking “Submit” below, you acknowledge that you have read, understood, and agree to these terms and conditions.