Notice of Privacy Practices

Effective Date: July 17, 2026
Last Updated: July 17, 2026

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.

Urgent Psych Rx is committed to protecting the privacy and security of your health information. This HIPAA Notice of Privacy Practices explains how we may use and disclose your protected health information, also called PHI, and describes your rights regarding your health information.

This notice applies to healthcare services provided by Urgent Psych Rx, including psychiatric evaluations, medication management, telehealth services, care coordination, targeted case management when applicable, therapy-related support, Spravato evaluation, and related behavioral health services.

Our Responsibilities

Urgent Psych Rx is required by law to:

• Maintain the privacy and security of your protected health information.
• Provide you with this Notice of Privacy Practices.
• Follow the terms of the notice currently in effect.
• Notify you if a breach occurs that may have compromised the privacy or security of your unsecured protected health information.
• Not use or share your health information other than as described in this notice, unless you authorize us in writing or the law permits or requires us to do so.

We are committed to using reasonable administrative, technical, and physical safeguards to protect your health information.

Your Rights

When it comes to your health information, you have certain rights.

Get an Electronic or Paper Copy of Your Medical Record

You may ask to see or receive an electronic or paper copy of your medical record and other health information we maintain about you.

We will provide a copy or summary of your health information, usually within the time required by law. We may charge a reasonable, cost-based fee when permitted by law.

Ask Us to Correct Your Medical Record

You may ask us to correct health information about you that you believe is incorrect or incomplete.

We may deny your request in certain situations, but we will explain the reason in writing.

Request Confidential Communications

You may ask us to contact you in a specific way, such as by phone, email, patient portal, or mail, or to send information to a different address.

We will accommodate reasonable requests when possible.

Ask Us to Limit What We Use or Share

You may ask us not to use or share certain health information for treatment, payment, or healthcare operations.

We are not required to agree to every request, but we will consider your request.

If you pay for a healthcare service or item out of pocket in full, you may ask us not to share that information with your health plan for payment or healthcare operations, unless we are required by law to do so.

Get a List of Certain Disclosures

You may ask for a list of certain times we have shared your health information. This is called an accounting of disclosures.

The list may not include all disclosures, such as those made for treatment, payment, healthcare operations, or disclosures you authorized.

Get a Copy of This Notice

You may ask for a paper copy of this notice at any time, even if you agreed to receive the notice electronically.

A copy of this notice will also be available on our website.

Choose Someone to Act for You

If you have given someone medical power of attorney, or if someone is your legal guardian or legally authorized representative, that person may exercise your rights and make choices about your health information as permitted by law.

We may verify the person’s authority before acting on the request.

File a Complaint

You may file a complaint if you believe your privacy rights have been violated.

You may contact Urgent Psych Rx using the contact information at the end of this notice.

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.

Urgent Psych Rx will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you may tell us your choices about what we share.

You may tell us whether we may share information with:

• Family members
• Friends
• Caregivers
• Others involved in your care
• Others involved in payment for your care

If you are unable to tell us your preference, for example because of an emergency or incapacity, we may share your information if we believe it is in your best interest or necessary to reduce a serious and imminent threat to health or safety.

Uses and Disclosures That Usually Require Written Authorization

We will generally obtain your written authorization before using or disclosing your protected health information for:

• Most uses and disclosures of psychotherapy notes, when applicable.
• Marketing communications that require authorization under HIPAA.
• Sale of protected health information.
• Other uses and disclosures not described in this notice.

You may revoke your authorization in writing at any time, except to the extent we have already relied on it.

How We May Use and Disclose Your Health Information

Treatment

We may use and share your health information to provide, coordinate, or manage your care.

For example, a provider may review your symptoms, medication history, prior treatment, lab information, referral notes, and clinical history to support psychiatric evaluation, medication management, or treatment planning.

We may also share information with other healthcare providers involved in your care, such as therapists, primary care providers, pharmacies, hospitals, laboratories, specialists, or other treating professionals.

Payment

We may use and share your health information to bill and receive payment from you, your health plan, or another responsible party.

For example, we may share information with your insurance plan to support eligibility checks, benefit verification, claims submission, prior authorization, medical necessity review, billing, payment, or appeals.

Healthcare Operations

We may use and share your health information for healthcare operations and business activities.

For example, we may use health information for quality review, staff training, credentialing, compliance, auditing, patient communication, care coordination, scheduling, billing support, legal review, business management, and improving services.

Appointment Reminders and Care Communications

We may use your health information to contact you about appointments, scheduling, follow-up care, medication-related matters, referrals, treatment planning, billing, insurance, or administrative issues.

Communications may occur by phone, voicemail, email, text message, patient portal, or mail, depending on the contact information you provide and your communication preferences.

Telehealth Services

If you receive telehealth services, we may use secure telehealth platforms, electronic health records, patient portals, or other technology to support virtual care.

We may use and disclose health information as needed to provide telehealth services, document care, coordinate treatment, support billing, and maintain clinical records.

Business Associates

We may share health information with vendors or contractors who perform services for Urgent Psych Rx.

These may include electronic health record vendors, billing companies, telehealth platforms, IT support, scheduling systems, patient portal vendors, insurance verification vendors, payment processors, document storage providers, legal advisors, accountants, consultants, or administrative service providers.

When required by law, these vendors must agree to protect your health information and use it only as allowed by their agreement with us.

Care Coordination and Referrals

We may use or share your health information to coordinate care, process referrals, communicate with referring providers, support therapy-related referrals, coordinate with case management resources, or connect you with appropriate services.

Health Information Exchanges and Electronic Systems

When applicable, we may share information through electronic health records, health information exchanges, pharmacies, laboratories, or other healthcare systems to support treatment, payment, or healthcare operations.

Required by Law

We may use or disclose your health information when required to do so by federal, state, or local law.

Public Health and Safety

We may disclose health information for public health and safety purposes, including:

• Preventing or controlling disease, injury, or disability.
• Reporting certain diseases, injuries, or events as required by law.
• Reporting adverse events or product concerns.
• Reporting suspected abuse, neglect, or domestic violence as required or permitted by law.
• Preventing or reducing a serious threat to the health or safety of you, another person, or the public.

Health Oversight Activities

We may disclose health information to health oversight agencies for activities authorized by law.

These activities may include audits, investigations, inspections, licensure, credentialing, disciplinary actions, compliance reviews, or other oversight activities.

Legal Proceedings

We may disclose health information in response to a court order, subpoena, discovery request, administrative order, or other lawful legal process when permitted or required by law.

Law Enforcement

We may disclose health information for law enforcement purposes when permitted or required by law.

Coroners, Medical Examiners, and Funeral Directors

We may disclose health information to coroners, medical examiners, or funeral directors as permitted by law.

Workers’ Compensation

We may disclose health information as authorized by workers’ compensation laws or similar programs.

Research

We may use or disclose health information for research only when permitted by law and with required privacy protections in place.

Specialized Government Functions

We may disclose health information for certain government functions, such as military, national security, protective services, correctional institution, or lawfully authorized government programs, when permitted by law.

Mental Health, Substance Use, and Sensitive Health Information

Mental health information, psychotherapy notes, substance use disorder information, HIV-related information, genetic information, and other sensitive information may receive additional protections under federal or state law.

Urgent Psych Rx will follow applicable federal and state privacy laws when using or disclosing sensitive health information.

Psychotherapy Notes

Psychotherapy notes, when maintained separately from the rest of the medical record, may receive additional privacy protections under HIPAA.

Urgent Psych Rx will generally obtain written authorization before using or disclosing psychotherapy notes, except where use or disclosure is permitted or required by law.

Substance Use Disorder Information

Certain substance use disorder treatment records may receive additional protections under federal confidentiality rules, including 42 CFR Part 2, if those rules apply.

When additional protections apply, Urgent Psych Rx will follow the applicable requirements before using or disclosing those records.

Spravato-Related Information

If you receive evaluation or treatment related to Spravato, your health information may be used or disclosed for treatment, payment, healthcare operations, safety monitoring, prior authorization, REMS-related requirements, care coordination, and compliance with applicable law.

Spravato is a prescription treatment. Evaluation is required before treatment recommendations are made. Eligibility is determined by a licensed provider. Individual results vary.

Spravato treatment at Urgent Psych Rx is currently available in person at the Grand Prairie, Texas location only.

Family Members, Caregivers, and Personal Representatives

We may share relevant health information with a family member, caregiver, personal representative, or other person involved in your care or payment for your care when permitted by law and consistent with your preferences.

If you object to certain disclosures, please notify us.

In some situations, we may share information when necessary to prevent serious harm, support care, or comply with the law.

Minors and Parents or Guardians

For patients who are minors, parents, guardians, or legally authorized representatives may have rights to access health information as permitted by applicable law.

In some situations, minors may have privacy rights regarding certain healthcare services. Urgent Psych Rx will follow applicable federal and state laws.

Communications by Email, Text, Phone, and Portal

Urgent Psych Rx may communicate with you by phone, voicemail, email, text message, patient portal, or mail for appointment reminders, scheduling, billing, care coordination, treatment-related communication, and administrative purposes.

Some communication methods may not be fully secure. Please notify us if you have communication preferences or restrictions.

Do not use email, text message, voicemail, website forms, or social media for emergencies or urgent safety concerns.

Emergency and Crisis Situations

Urgent Psych Rx is not an emergency or crisis service.

If you or someone else may be in immediate danger, call 911, call or text 988, or go to the nearest emergency room.

Do not use the website, email, voicemail, patient portal, contact forms, or social media for emergencies, urgent psychiatric crises, medication emergencies, or immediate safety concerns.

Breach Notification

If a breach occurs involving unsecured protected health information, we will notify affected individuals as required by law.

Changes to This Notice

We may change the terms of this Notice of Privacy Practices at any time. The revised notice may apply to health information we already have about you as well as information we receive in the future.

The current notice will be posted on our website and will be available upon request.

Questions or Complaints

If you have questions about this notice, want to exercise your privacy rights, or wish to file a complaint, please contact:

Privacy Officer
Urgent Psych Rx
2455 Robinson Rd Ste. 100
Grand Prairie, Texas 75051
Phone: +1 (469) 626-8195
Email: in**@***********rx.com

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.

Urgent Psych Rx will not retaliate against you for filing a complaint.