Privacy Policy
Notice of Privacy Practices
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.
STS Psychology & Consulting, PLLC, d/b/a Mind Mosaic Psychology (“Mind Mosaic Psychology” or "Practice"), is a group practice co-owned by Sarah Smead, LPA, and Taylor Shirkey, LPA. This Practice functions as an organized health care arrangement, meaning our providers and staff may share your protected health information (PHI) with one another as necessary to carry out treatment, payment, and health care operations.
STS Psychology & Consulting, PLLC d/b/a Mind Mosaic Psychology (the "Practice" or "Mind Mosaic Psychology”) is committed to protecting your privacy. The Practice is required by federal law to maintain the privacy of Protected Health Information (“PHI”), which is information that identifies or could be used to identify you. The Practice is required to provide you with this Notice of Privacy Practices (this “Notice”), which explains the Practice's legal duties and privacy practices and your rights regarding PHI that we collect and maintain.
Your Rights
Your rights regarding PHI are explained below. To exercise these rights, please submit a written request to the Practice at the address noted below.
To inspect and copy PHI.
You have the right to inspect and obtain a copy of your protected health information (PHI) that may be used to make decisions about your care. You may request an electronic or paper copy of your records. You also have the right to request that we transmit an electronic copy of your PHI directly to a third party or a personal health application of your choice. We will provide a copy or a summary of your health information, usually within 30 days of your written request. We may charge a reasonable, cost-based fee for the costs of copying, mailing, or other supplies associated with your request.
We may deny your request to inspect and copy PHI in certain very limited circumstances. For example, we may deny access if a licensed healthcare professional in our practice determines, in their professional judgment, that the access requested is reasonably likely to endanger your life or physical safety or that of another person. Additionally, under North Carolina law, we may deny access if a licensed professional determines that the disclosure would be injurious to your physical or mental well-being. If you are denied access for this reason, you have the right to have the denial reviewed. Mind Mosaic Psychology will designate a licensed healthcare professional to review your request and the denial; this person will not have been involved in the original decision to deny access. We will comply with the outcome of that review.
To amend PHI.
You can ask to correct PHI you believe is incorrect or incomplete. The Practice may require you to make your request in writing and provide a reason for the request.
The Practice may deny your request. The Practice will send a written explanation for the denial and allow you to submit a written statement of disagreement.
To request confidential communications.
You can ask the Practice to contact you in a specific way. The Practice will say “yes” to all reasonable requests.
To limit what is used or shared.
You can ask the Practice not to use or share PHI for treatment, payment, or business operations. The Practice is not required to agree if it would affect your care.
If you pay for a service or health care item out-of-pocket in full, you can ask the Practice not to share PHI with your health insurer.
You can ask for the Practice not to share your PHI with family members or friends by stating the specific restriction requested and to whom you want the restriction to apply.
To obtain a list of those with whom your PHI has been shared.
You can ask for a list, called an accounting, of the times your health information has been shared. You can receive one accounting every 12 months at no charge, but you may be charged a reasonable fee if you ask for one more frequently.
To receive a copy of this Notice.
You can ask for a paper copy of this Notice, even if you agreed to receive the Notice electronically.
To choose someone to act for you.
If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights.
To file a complaint if you feel your rights are violated.
You can file a complaint by contacting the Practice using the following information:
Sarah Smead, Privacy Officer360 N. Caswell Road
(704) 765-2549If you are concerned that I have violated your privacy rights, or you disagree with a decision I made about access to your records, you may contact me, the State of North Carolina Department of Health, or the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting
www.hhs.gov/ocr/privacy/hipaa/complaints/.The Practice will not retaliate against you for filing a complaint.
To opt out of receiving fundraising communications.
The Practice may contact you for fundraising efforts, but you can ask not to be contacted again.
We will never market or sell personal information.
Our Uses and Disclosures
1. Routine Uses and Disclosures of PHI:
The Practice is permitted under federal law to use and disclose PHI, without your written authorization, for certain routine uses and disclosures, such as those made for treatment, payment, and the operation of our business. Once PHI is shared with authorized third parties, it may be subject to redisclosure by the recipient and may no longer be protected by federal HIPAA privacy rules.The Practice typically uses or shares your health information in the following ways:
To treat you.
The Practice can use and share PHI with other professionals who are treating you.
Example: Your primary care doctor asks about your mental health treatment.
To run the health care operations.
The Practice can use and share PHI to run the business, improve your care, and contact you.
Example: The Practice uses PHI to send you appointment reminders if you choose.
To bill for your services.
The Practice can use and share PHI to bill and get payment from health plans or other entities.
Example: The Practice gives PHI to your health insurance plan so it will pay for your services.
2. Substance Use Disorder (SUD) Records:
If the Practice creates or receives records regarding Substance Use Disorder treatment from a federally assisted program (42 CFR Part 2), these records are subject to stricter confidentiality protections. We generally cannot disclose these records in civil, criminal, administrative, or legislative proceedings against you without your specific written consent or a special court order. If we share your PHI with your consent for treatment or operations, and that PHI includes SUD records, the recipient is also prohibited from redisclosing those records except as permitted by law.
3. Uses and Disclosures of PHI That May Be Made Without Your Authorization or Opportunity to Object
The Practice may use or disclose PHI without your authorization or an opportunity for you to object, including:
To help with public health and safety issues
Public health: To prevent the spread of disease, assist in product recalls, and report adverse reactions to medication.
Required by the Secretary of Health and Human Services: We may be required to disclose your PHI to the Secretary of Health and Human Services to investigate or determine our compliance with the requirements of the final rule on Standards for Privacy of Individually Identifiable Health Information.
Health oversight: For audits, investigations, and inspections by government agencies that oversee the health care system, government benefit programs, other government regulatory programs, and civil rights laws.
Serious threat to health or safety: To prevent a serious and imminent threat.
Abuse or Neglect: To report abuse, neglect, or domestic violence.
To comply with law, law enforcement, or other government requests
Required by law: If required by federal, state or local law.
Judicial and administrative proceedings: To respond to a court order, subpoena, or discovery request.
Law enforcement: For law locate and identify you or disclose information about a victim of a crime.
Specialized Government Functions: For military or national security concerns, including intelligence, protective services for heads of state, or your security clearance.
National security and intelligence activities: For intelligence, counterintelligence, protection of the President, other authorized persons or foreign heads of state, for purpose of determining your own security clearance and other national security activities authorized by law.
Workers' Compensation: To comply with workers' compensation laws or support claims.
To comply with other requests
Coroners and Funeral Directors: To perform their legally authorized duties.
Organ Donation: For organ donation or transplantation.
Research: For research that has been approved by an institutional review board.
Inmates: The Practice created or received your PHI in the course of providing care.
Business Associates: To organizations that perform functions, activities or services on our behalf.
4. Uses and Disclosures of PHI That May Be Made With Your Authorization or Opportunity to Object
Unless you object, the Practice may disclose PHI:
To your family, friends, or others if PHI directly relates to that person's involvement in your care.
If it is in your best interest because you are unable to state your preference.
5. Uses and Disclosures of PHI Based Upon Your Written Authorization
The Practice must obtain your written authorization to use and/or disclose PHI for the following purposes:
Marketing, sale of PHI, and psychotherapy notes.
You may revoke your authorization, at any time, by contacting the Practice in writing, using the information above. The Practice will not use or share PHI other than as described in Notice unless you give your permission in writing.
Our Responsibilities
Requirements
The Practice is required by law to maintain the privacy and security of PHI.
The Practice is required to abide by the terms of this Notice currently in effect. Where more stringent state or federal law governs PHI, the Practice will abide by the more stringent law.
The Practice reserves the right to amend Notice. All changes are applicable to PHI collected and maintained by the Practice. Should the Practice make changes, you may obtain a revised Notice by requesting a copy from the Practice, using the information above, or by viewing a copy on the website: https://mindmosaicpsych.com/privacy
The Practice will inform you if PHI is compromised in a breach.
This Notice is effective on February 9, 2026
Frequently Asked Questions: Privacy
-
We adhere to the strictest ethical standards and HIPAA regulations. Your personal information, testing data, and clinical notes are stored in a secure, encrypted Electronic Health Record (EHR) system accessible only by your care team.
-
Never without your explicit consent. We will only speak with or send reports to your child’s school, pediatrician, or other providers if you sign a formal Release of Information (ROI) form.
-
HIPAA (Health Insurance Portability and Accountability Act) is a federal law that protects sensitive patient health information from being disclosed without the patient's consent. It guarantees your right to privacy in all of our communications.
-
Yes. Our Notice of Privacy Practices is provided to all clients during the intake process through the secure portal, and you can request a copy from our office at any time.
