This notice contains important information about Nurturing Spirit Acupuncture’s 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 and sign at the bottom to acknowledge that this information has been provided to you.
Effective Date: February 16, 2026
Previous version issued on: August 11, 2020
This Notice is effective as of the date stated above and supersedes any prior notices. We reserve the right to revise this Notice and make the new provisions effective for all protected health information we maintain, including information created or received prior to the effective date of the revised Notice.
I. What is this notice?
In order to provide care to patients, Nurturing Spirit Acupuncture and its affiliates must collect, maintain, and use protected health information (PHI) on patients to whom it provides services. This information is considered private and confidential and policies and procedures are in place to protect the information against unlawful use and disclosure. This notice describes what types of information are collected, Nurturing Spirit Acupuncture’s legal duties, and its privacy practices. It also describes your rights to access and control your protected health information (PHI).
Nurturing Spirit Acupuncture (hereafter abbreviated NSA) is required to abide by the terms of this notice. However, NSA may modify the terms of this notice at any time, and the new notice will be effective for all PHI in its possession at the time of the change, and any created or received thereafter.
Information NSA collects, uses and maintains about you is protected by Federal and District laws: the Health Insurance Portability and Accountability Act (HIPAA) and relevant sections of the District of Columbia Official Code. NSA does not disclose PHI to anyone, except with your authorization or otherwise as permitted by law.
II. What is “protected health information” (PHI)?
Protected health information (PHI) is information that identifies you as an individual and relates to you participation in treatment, your physical or mental health/condition, the provision of treatment or healthcare to you or payment to NSA for the provision of services provided to you.
III. How does NSA protect PHI?
Within NSA, PHI is accessed only your acupuncturist, Kate Quinn Stewart, L.Ac. Physical and procedural safeguards are maintained to protect your information against unauthorized access and use.
IV. How does NSA use non-public personal information (PHI) and for what purpose?
Here are some examples of what NSA does with the information collected and the reason it might be used.
Treatment: Kate Quinn Stewart, L.Ac. uses information about you to provide acupuncture treatment and related health and wellness services to you, to make record of treatments you receive, and to monitor your response to those treatments.
Payment: NSA may use and disclose PHI so that treatment and services you receive may be billed to and payment collected from you or a third party. NSA may also use and disclose your PHI to obtain payment from other third parties that may be responsible for the costs, such as family members.
V. What use and disclosures do not require your authorization?
NSA may use and disclose PHI without your authorization for the following purposes:
Business Associates: NSA may contract with outside individuals and organizations that perform business services for NSA such as billing, scheduling, accountants, or attorneys. In certain circumstances, NSA may need to share your information with a business associate so it can perform a service on NSA’s behalf. NSA will limit the disclosure of information to a business associate to the amount of information that is the minimum necessary for the business associate to perform services for NSA. In addition, NSA will have an agreement in place (called a business associates agreement, or BAA) with the business associate requiring it to protect the privacy of your information.
As Required by Law: NSA will disclose PHI when required to do so by federal, state, or local law.
Public Health Activities/Risks: NSA may disclose PHI to public health authorities that are authorized by law to collect information for the purpose of:
• Reporting child abuse or neglect
• Preventing or controlling disease, injury, or disability
• Notifying a person regarding potential exposure to a communicable disease
• Notifying a person regarding the potential risk for spreading a disease or condition
• Reporting reactions to drugs or problems with products or device
• Notifying individuals if a product or device NSA may be using has been recalled
• Notifying appropriate government agencies and authorities regarding the potential abuse or neglect of an adult patient, including domestic violence
Health Care Oversight Activities: NSA may disclose PHI to a health oversight agency for activities authorized by law. Oversight activities can include investigations, inspections, audits, surveys, licensure and disciplinary actions; civil administrative and criminal procedures or actions; or other activities necessary for the government to monitor compliance with civil rights laws and the health care system in general.
Lawsuits and Disputes: NSA may use and disclose PHI in response to a court or administrative order if you are involved in a lawsuit or similar proceeding. NSA may also disclose your PHI in response to a discovery request, subpoena or other lawful processes by another party involved in the dispute, but only if NSA have made an effort to inform you of the request or to obtain a court order protecting the information the party has requested.
Law Enforcement: NSA may disclose PHI if asked to do so by a law enforcement official as part of law enforcement activities; in investigations of criminal conduct at the NSA or of victims of crime; in emergencies in order to report a crime (including the location or victims(s) of the crime, or the description, identity or location of the perpetrator); or when required to do so by law.
Serious Threats to Health or Safety: NSA may use and disclose your PHI when necessary to reduce or to prevent a serious threat to your health and safety or the health and safety of another individual or the public. Under these circumstances, NSA will only make disclosures to a person or organization able to help prevent the threat.
In Emergency Medical Situations: If you experience a medical emergency during an appointment with Kate Quinn Stewart, L.Ac. or on the way to or from your appointment and the intervention of emergency medical first responders is called for, she will disclose to those first responders any PHI necessary for them to provide you with appropriate care.
Military: NSA may use and disclose PHI if you are a member of the Unites States or foreign military forces (including veterans) and if required by the appropriate military command authorities.
When the Patient is a Minor: NSA will disclose PHI to parents or legal guardians of minor children for the purpose of delivering and explaining treatment and expected treatment outcomes, providing information about home care that will support treatment, or for any other purpose that would assist the parent or guardian in tending to the child’s health and wellbeing. In the case of older children who might benefit from some additional privacy, the patient, parent(s) or guardian(s), and NSA may create and sign a written agreement about what PHI the child would like to have kept private from the parent(s) or guardian(s). Such an agreement will be evaluated on a case-by-case basis and shall not restrict any of the disclosures of PHI listed in section V of this document as not requiring authorization. If no such written agreement is in place, NSA will disclose any and all PHI deemed to be relevant to the child’s parent(s) or guardian(s) except as detailed elsewhere in this document.
VI. What uses and disclosures of PHI require your authorization?
Individuals Involved in Your Care or Payment for Your Care: NSA may release PHI to a friend or family member identified by you, who is helping you pay for your treatment or who assists in taking care of you. If you are an adult patient, you will need to identify this individual and authorize disclosure of PHI in writing.
Other Medical and Mental Health Practitioners: If you wish for NSA to disclose your PHI to another practitioner for the purpose of coordinating care or sharing information about your condition and/or progress, you may request to fill out and sign a Release of Protected Health Information form that authorizes such a disclosure.
VII. What are your rights governing the information that Kate Quinn Stewart, L.Ac. collects, uses and maintains on you?
The Right to Inspect and Copy: You have the right to inspect and obtain a copy of your PHI that NSA maintains and has in its possession, including treatment records and billing records. If you request copies, NSA will charge you a fee for the costs of copying, compiling, mailing, labor, and supplies associated with your request. NSA will notify you of the cost involved and you may choose to withdraw or modify your request at the time before any costs are incurred. To inspect and copy your PHI, you must send your request in writing to NSA’s mailing address, listed at the bottom of this form. You may also bring your written request with you to a scheduled appointment. Under certain circumstances NSA may deny your request to inspect and copy your PHI.
The Right to Amend or Correct PHI: If you feel that any PHI NSA has about you is not correct or is incomplete, you may ask NSA to correct or amend the information. You have the right to request an amendment for as long as the information is kept by NSA (three years after our last contact for an adult patient, three years after reaching the age of majority for a minor patient). To request an amendment, your request must be made in writing to the address at the bottom of this form. Additionally, you must provide a reason that supports your request.
NSA reserves the right to deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, NSA may deny your request if you ask us to amend information that
• Was not created by NSA
• Is not part of the medical information kept by NSA
• Is not part of the information which you would be permitted to inspect and copy, or
• Is accurate and complete.
The Right to an Accounting of Disclosures: An accounting of disclosures is a list of the disclosures NSA has made, if any, of your PHI.
You have the right to request an accounting of disclosures made by NSA. This right applies to disclosures for purposes other than those made to carry out treatment, payment and health care operations as described in this notice. It also excludes communications of PHI made to you or disclosures authorized by you.
Your request must be made in writing and state a time period that cannot be longer than 3 years. NSA may charge you for the costs of providing the list. NSA will notify you of the cost involved and you may choose to withdraw or modify your request at the time before any costs are incurred.
The Right to Receive Communications of PHI by Alternative Means or at Alternative Locations: You have the right to request that NSA communicate with you about your treatment and related issues in a particular manner or at a certain location. For example, you may ask that NSA contact you at work rather than at home. NSA will accommodate all reasonable requests made in writing.
The Right to Request Restrictions: You have the right to request a restriction or limitation on the PHI NSA uses or discloses about you for treatment, payment or health care operations as described in this notice. You also have the right to request a limit on the treatment information NSA discloses about you to someone who is involved in your case or the payment for your care (like a family member or friend).
NSA is not required to agree to your request, however, if NSA does agree, NSA will comply with your request until notice is received from you that you no longer want the restriction to apply.
Any request for a restriction on NSA’s use and disclosure of your PHI must be made in writing to the address at the bottom of this form. Your request must describe in a clear and concise manner: (a) the information you wish restricted; (b) whether you are requesting to limit NSA’s use, disclosure or both; and (c) to whom you want the limits to apply.
The Right to Provide an Authorization for Other Uses and Disclosures: NSA will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law. Any authorization you provide to NSA regarding the use and disclosure of your PHI may be revoked at any time in writing to the address below. The authorization will be considered in effect until and unless NSA receives a written revocation from you. After you revocation is received, NSA will no longer use or disclose your PHI for the purposes described in the authorization, except under the following circumstance:
• NSA has acted in reliance upon your authorization before NSA receive your written revocation
The Right to Obtain a Paper Copy of This Notice: You have the right print out this form or to obtain a paper copy of this notice of privacy practices at any time.
VIII. Changes to the Terms of this Notice
NSA can change the terms of this notice, and the changes will apply to all information NSA has about you. The new notice will be available upon request, in the office. You will be provided with the revised notice it in the office, and you will be provided with a copy of the revised notice upon your next service delivery date following the revision or upon request.
SUD Treatment Information
If NSA receives or maintains any information about you from a substance use disorder treatment program that is covered by 42 CFR Part 2 (a “Part 2 Program”) through a general consent you provide to the Part 2 Program to use and disclose the Part 2 Program record for purposes of treatment, payment or health care operations, NSA may use and disclose your Part 2 Program record for treatment, payment and health care operations purposes as described in this Notice. If NSA receives or maintains your Part 2 Program record through specific consent you provide to NSA or another third party, NSA will use and disclose your Part 2 Program record only as expressly permitted by you in your consent as provided to NSA.
In no event will NSA use or disclose your Part 2 Program record, or testimony that describes the information contained in your Part 2 Program record, in any civil, criminal, administrative, or legislative proceedings by any Federal, State, or local authority, against you, unless authorized by your consent or the order of a court after it provides you notice of the court order.
NSA does not engage in any fundraising, therefore any records subject to 42 CFR Part 2 will not be used or disclosed for fundraising purposes.
Notice Regarding Additional Protections
There are certain types of highly confidential information that are specifically addressed in certain federal and state laws and regulations, which further restrict the use and disclosure of this type of highly confidential information. This highly confidential information, including alcohol and substance abuse treatment information (including but not limited to SUD records protected under 42 C.F.R. Part 2), HIV and sexually transmitted disease-related information, mental health information, psychotherapy information, genetic information, and pregnancy of minors, as well as some other sensitive information, is considered so sensitive that some federal and applicable state laws provide special protections for it. All uses or disclosures of such highly sensitive information must meet the requirements of such applicable law. Therefore, there may be greater protections under applicable law for such highly sensitive information. As mentioned above, please note that State confidentiality laws may impose additional or different requirements beyond HIPAA and Part 2.
If you have questions or concerns about the ways this type of highly confidential information may be used or disclosed, or if you wish to request restrictions on the use or disclosure of such information, please contact us at the address below.
IX. Address for Written Correspondence
Any written requests, authorizations, or revocations of authorization regarding PHI may either be brought in person to an office visit at NSA or mailed to the address below:
Nurturing Spirit Acupuncture
1633 Q St, NW, Suite 200
Washington, DC 20009