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 REPORT ANY ISSUES, OR CONCERNS, TO: Pettable, Inc. (“Pettable”) 2810 N Church St, Suite 67131. Wilmington, Delaware 19802-4447.
The Health Insurance Portability & Accountability Act of 1996 (HIPAA) is a federal law requiring that all medical records and other individually identifiable health information used, or disclosed, by us in any form, including whether electronically, via video or teleconference, or orally, are kept properly confidential. HIPAA gives you, the Patient, rights to understand and control how your health information is used. HIPAA provides penalties for covered entities that misuse protected health information.
We have prepared this “Notice of HIPAA Privacy Practices” (Notice) to explain how we maintain the privacy of your health information and how we may use and disclose your health information. We are a Business Associate under HIPAA, and not required by law to maintain or provide this Notice. Nonetheless, we strive to foster confidence between you and us with respect to your protected health information and maintain this Notice as a courtesy to provide information on how we may use your protected health information. We also work closely with your clinicians and practitioners who furnish clinical care to collaboratively properly maintain your protected health information. We will notify you if we experience a breach of your unsecured protected health information. We will follow the terms of this Notice and we may amend the Notice if we change any of our privacy policies or practices. We can change the terms of this Notice, and the changes will apply to all information we have about you. The new notice will be available on our web site and in the Pettable Portal, accessible at app.pettable.com.
As a business associate to our independently contracted network of therapists and clinicians (“Clinicians”), we may use and disclose your medical records for each of the following purposes: treatment, payment, and health care operations:
TREATMENT means providing, coordinating, or managing health care and related services by one or more health care providers including the Clinicians.
PAYMENT means such activities as obtaining payment or reimbursement for services, billing or collection activities and utilization review.
HEALTH CARE OPERATIONS include managing your Pettable Portal, to facilitate therapeutic consultations with associated Clinicians, as well as conducting quality assessment review and service improvement planning activities, auditing functions, and customer service.
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes, including:
Further, we may create and distribute de-identified health information by removing all references to individually identifiable information.
We may contact you to provide information about our services or other health-related services that may be of interest to you.
Any other uses and disclosures will be made only with your written authorization. You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization.
You may exercise the following options with respect to your protected health information, by presenting a written request to your Clinician.
You have the right to request from Clinician restrictions on the ways we use and disclose your health information for treatment, payment, and healthcare operations. You may also request that we limit our disclosures to persons assisting your care. We will consider your request, but are not required to accept it.
You have the right to request from Clinician that you receive communications containing your protected health information from us by alternative means or at alternative locations. For example, you may ask that we only contact you at home or by mail.
Except under certain circumstances, you may inspect and copy medical, billing and other records used to make decisions about you. If you ask for copies of this information, we may charge you a nominal fee for copying, packaging, and postage.
If you believe that information in your records is incorrect, or incomplete, you have the right to ask your Clinician to correct the existing information, or add missing information. Under certain circumstances, we may deny your request, such as when the information is accurate and complete.
You have the right to request from your Clinician a list of certain instances when we have used or disclosed your medical information. If you ask for this information from us more than once every twelve months, charges may apply, to cover our costs for administration, archive retrieval, copying, packaging, and postage. Upon request, you have a right to receive a paper copy of this notice.
You can complain if you feel we have violated your rights by contacting at (855) 920-0323. You can file a complaint with 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/. We will not retaliate against you for filing a complaint.
This Notice is effective July 1, 2024
Pettable, Inc.
(855) 920-0323
Effective July 15, 2024
Pettable’s Privacy Policy describes how Pettable handles your personal information generally. Nevada and Washington law require specific disclosures regarding consumer health data. This Consumer Health Data Policy (“Policy”) supplements our Privacy Policy and describes how we collect, use, and share your consumer health data.
In providing our Services, we may collect protected health information as defined by the Health Insurance Portability and Accountability Act (“HIPAA”) as a business associate to your provider. This Policy does not apply to protected health information. If you have questions about how your protected health information is handled, please refer to your provider’s Notice of Privacy Practices.
Consumer health data we collect
“Consumer health data” is personal information that identifies your past, present, or future physical or mental health status. Pettable collects consumer health data from the following sources:
As described in our Privacy Policy, the information we collect depends on the context of your interactions with Pettable. We may collect the following consumer health data:
Our use of consumer health data
We use your consumer health data to:
How we share consumer health data
We may share your consumer health data:
How to exercise your rights
As a Nevada or Washington resident, you have the right to request access to and/or deletion of your consumer health data. You also have the right to withdraw consent if we are processing your consumer health data with your consent. To exercise these rights, please email us at [email protected]. If we deny your request, you have the right to appeal our decision by emailing [email protected].
Changes to this Policy
We will update this Policy when necessary to reflect changes in how we use consumer health data or the applicable law. When we post changes to this Policy, we will revise the “Effective” date at the top of the Policy.
How to contact us
For questions about our privacy practices, contact us at [email protected]
These Service Terms constitute a legal agreement between you and Pettable, Inc. (“Pettable”, or “us”) regarding your use of our services. PLEASE READ THESE SERVICE TERMS CAREFULLY BEFORE USING OUR SERVICES. THEY CONTAIN IMPORTANT INFORMATION REGARDING YOUR LEGAL RIGHTS, INCLUDING A WAIVER OF THE RIGHT TO A JURY TRIAL. BY CLICKING “I ACCEPT” AS PART OF THE REGISTRATION PROCESS YOU AGREE TO BE LEGALLY BOUND BY:
IF YOU DO NOT AGREE WITH THESE SERVICE TERMS OR THE TELEHEALTH CONSENT DOCUMENTS, DO NOT USE THE PETTABLE SERVICES OR THE PETTABLE PLATFORM.
Who may receive my information: By signing below, I authorize the licensed mental health professional and their employees and agents (collectively "Licensed Mental Health Professional") to give out health information about me as described below to Pettable, Inc. and I authorize Pettable, Inc. to provide health information I provide to Pettable to the licensed mental health professional with whom Pettable facilities my scheduling.
Description of information to be used or disclosed:
Purpose of the disclosure: I am requesting that this information be disclosed for any purpose deemed necessary or advisable by Pettable.
Who may disclose information: I hereby authorize Pettable and my Licensed Mental Health Professional to provide my information outlined above.
How information may be disclosed: I authorize my information to be exchanged between Pettable and the Licensed Mental Health Professional electronically, via telephone, facsimile, or through any other means the Pettable or the Licensed Mental Health Professional deem appropriate. I authorize Pettable to include my information in a database that may help Pettable and the Licensed Mental Health Professional access my information more efficiently.
Re-disclosure: I hereby acknowledge that once a Licensed Mental Health Professional gives my information to Pettable, Pettable may re-disclose it. If my information is disclosed to or received by Pettable or other individual or entity that is not subject to state or federal privacy laws, my information may no longer be protected.
Revoking permission: I may revoke this authorization at any time, except to the extent that action has been taken in reliance on this authorization or other law allows Pettable to contest a claim under the policy or to contest the policy itself. I can revoke this authorization by sending a written request to the Licensed Mental Health Professional as set forth in the professional notice of privacy practices as to the Licensed Mental Health Professional and by sending a written request to Pettable as to Pettable. I understand that my revocation will not affect any disclosures made before the date I withdrew my permission.
Effect of refusal to sign: I understand that the signing of this authorization is voluntary. Pettable will not condition treatment, payment, enrollment or eligibility for benefits on my signing this authorization.
Expiration and other provisions: This authorization will be valid when revoked by the patient in writing, or as provided by law, whichever occurs first.. A copy of this authorization will be as valid as the original. I understand that I am entitled to receive a copy of this authorization.
I understand that Pettable will provide administrative services to facilitate connecting me with a licensed mental health professional (“the LMHP”) via our online platform to provide behavioral healthcare, including assessment, diagnosis, therapy, follow-up and/or education teletherapy includes consultation, treatment, transfer of personal and health information, emails, telephone conversations and education using interactive audio, video and data communications (“Telehealth”). Telehealth involves the use of electronic communications. I hereby consent to engage in Telehealth services with my LMHP. I understand that my LMHP is an independent contractor and is not employed by Pettable. My LMHP may require me to execute an additional informed consent prior to engaging in Telehealth.
I understand that the expected benefits of Telehealth are improved access to behavioral health care enabling me to remain at a remote site while the LMHP is at a distant site, more efficient evaluation and management and obtaining the expertise of a distant LMHP who is licensed in the state where I reside.
I understand that I have a right to confidentiality with Telehealth under the same laws that protect the confidentiality of my personal and health information for in-person behavioral health services. Any information disclosed by me during the course of my remote Telehealth, therefore, is generally confidential to the extent provided by law.
As with any medical care, there are potential risks associated with the use of Telehealth. These risks include, but may not be limited to: (a) in rare cases, information transmitted may not be sufficient (e.g. poor resolution of images) to allow for appropriate professional decision making by the LMHP; (b) delays in evaluation and treatment could occur due to deficiencies or failures of the equipment; and (c) the possibility of disruption, distortion or unauthorized access during transmission of personal information due to internet/electronic/technical failures beyond the control of Pettable and my LMHP.
By signing this form, I understand the following:
I have read and understand the information provided above regarding teletherapy and all of my questions have been answered to my satisfaction. By clicking the “I AGREE” button and typing my name at the bottom of this page, I am authorizing the LMHP to whom Pettable facilitates a connection to assess my mental health via Telehealth and confirming my agreement and understanding of the statements above. I hereby give my informed consent and authorization for my LHMP to use Telehealth in my healthcare.
I agree that a copy of this form may be treated as a signed original.