Banyan Integrated Health PLLC
Effective Date: June 9, 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.

Our Commitment to Your Privacy

Banyan Integrated Health PLLC ("BIH," "we," "our," or "us") is committed to protecting the privacy of your protected health information (PHI). We are required by federal law under the Health Insurance Portability and Accountability Act (HIPAA) to maintain the privacy of your health information, provide you with this Notice of our legal duties and privacy practices, and follow the terms of this Notice currently in effect.

How We May Use and Disclose Your Health Information

We may use and disclose your protected health information for the following purposes without your specific written authorization:

Treatment. We may use your health information to provide, coordinate, or manage your psychiatric care and related services. This includes consultation with other healthcare providers involved in your treatment and referrals for additional services.

Payment. We may use and disclose your health information to bill and collect payment for the services we provide, including verifying insurance eligibility and processing claims.

Healthcare Operations. We may use and disclose your health information for activities necessary to operate our practice, including quality assessment, provider training, business planning, and administrative activities.

Appointment Reminders. We may contact you to remind you of upcoming appointments or to provide information about treatment alternatives or health-related services.

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 your health information for public health activities, including reporting communicable diseases, abuse or neglect, or to prevent a serious threat to health or safety.

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

Legal Proceedings. We may disclose your health information in response to a court or administrative order, subpoena, or other lawful process.

Law Enforcement. We may disclose your health information to law enforcement officials for specific purposes permitted by law.

Workers' Compensation. We may disclose your health information as authorized by workers' compensation laws.

Special Protections for Mental Health Information

Mental health information, including psychotherapy notes, receives additional protection under federal and North Carolina state law. In most cases, we will not disclose psychotherapy notes without your specific written authorization, except as permitted or required by law.

Uses and Disclosures Requiring Your Authorization

The following uses and disclosures require your written authorization:

• Most uses and disclosures of psychotherapy notes

• Uses and disclosures for marketing purposes

• Disclosures that constitute a sale of PHI

• Other uses and disclosures not described in this Notice

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

Your Rights Regarding Your Health Information

You have the following rights regarding your protected health information:

Right to Access. You have the right to inspect and obtain a copy of your health information that we maintain, with limited exceptions. Requests must be submitted in writing.

Right to Amend. If you believe your health information is incorrect or incomplete, you have the right to request that we amend it. We may deny your request under certain circumstances.

Right to an Accounting of Disclosures. You have the right to receive a list of certain disclosures we have made of your health information.

Right to Request Restrictions. You have the right to request restrictions on how we use or disclose your health information for treatment, payment, or healthcare operations. We are not required to agree to your request.

Right to Confidential Communications. You have the right to request that we communicate with you about your health information in a specific way or at a specific location.

Right to a Paper Copy of This Notice. You have the right to a paper copy of this Notice, even if you have agreed to receive it electronically.

Right to Notification of Breach. You have the right to be notified in the event of a breach of your unsecured protected health information.

Telehealth Services

When you receive services from BIH via telehealth, the same privacy and security protections apply as during in-person visits. We use only HIPAA-compliant, encrypted video conferencing platforms. Telehealth sessions are not recorded unless you provide specific written consent. Your provider will visually verify your identity at the start of each telehealth session.

How We Protect Your Information

We maintain physical, technical, and administrative safeguards to protect your health information, including:

• Encrypted electronic health records

• Secure, HIPAA-compliant telehealth platforms

• Access controls and authentication measures

• Workforce training on privacy and security

• Business Associate Agreements with all vendors who may access PHI

• Locked physical storage of any paper records

Changes to This Notice

We reserve the right to change this Notice at any time. Any changes will apply to all health information we maintain. The revised Notice will be posted on our website and available at our office.

How to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services. You will not be retaliated against for filing a complaint.

To file a complaint with BIH, contact: Graham Hayes, Director of Operations / Privacy Officer, Banyan Integrated Health PLLC 3303 Healy Drive, Suite B Winston-Salem, NC 27103 Phone: (336) 448-4451 Contact us

To file a complaint with HHS, contact: Office for Civil Rights U.S. Department of Health and Human Services 200 Independence Avenue, S.W. Washington, D.C. 20201 1-877-696-6775 www.hhs.gov/ocr/privacy/hipaa/complaints/

Acknowledgment

Patients receive a copy of this Notice at intake and acknowledge receipt through their electronic signature in our patient portal.