Enclosed you will find a detailed notice of privacy practices (this “Notice”) which details our confidentiality practices under federal (HIPAA) and New York State law. This Notice includes detailed information regarding the privacy rights of your person receiving services. A significant portion of this Notice outlines procedures which we have implemented in order to comply with certain mental health or mental hygiene laws. Please be sure to return the acknowledgement form attached to this Notice immediately (and in no event later than 72 hours from receipt) since federal law requires that you acknowledge receiving this Notice.
If you have any specific questions, feel free to call me at (718) 987-1234 ext.: 1030, or write to me at firstname.lastname@example.org or 49 Cedar Grove Avenue, Staten Island, NY 10306.