Sara Azorsky Pediatric Therapy Services 

Privacy Policy


This notice describes how health information about your child may be used and disclosed, and how you can get access to this information. Please review carefully. 

Sara Azorsky Pediatric Therapy Services, LLC (the “Practice”), is required by law to keep your health information safe. We maintain a record of the care and services your child receives to ensure high-quality care and comply with legal requirements. This notice will tell you about the ways in which we may use and disclose health information about you. We also describe your rights to the health information we keep about you, and describe certain obligations regarding the use and disclosure of your health information. This notice applies to all records of your child’s care generated by the Practice. This information may include the following:

  • Notes from doctors, teachers, or other healthcare providers

  • Medical history

  • Evaluation results

  • Treatment notes

  • Insurance information.

Your Rights

You have the right to: 

  • Minnesota Health Records Act. In addition to our compliance with the Health Insurance Portability and Accountability Act (HIPAA), we adhere to the Minnesota Health Records Act (Minn. Stat. §§ 144.291-144.298), which provides additional protections for your health information.

  • Access your health records. Within 30 days of your request (or 60 days if records are archived).

  • Get a copy of your child’s medical record. Other than “session notes,” you have the right to get an electronic or paper copy of your medical record and other information that we have about you. We will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request, and we may charge a reasonable, cost based fee for doing so.

  • Request a correction to your child’s record. If you believe information is incorrect or incomplete, you may ask us to correct it. We may say “no” to your request, but will tell you why in writing within 60 days of receiving your request.

  • Request confidential communications. You can ask us to contact you in a specific way (e.g., home phone) or send mail or electronic communications to a different address. We will agree to all reasonable requests.

  • Ask us to limit what we use or share. You have the right to ask us not to use or disclose certain health information for treatment, payment, or health care operations purposes. We are not required to agree, but will do so when possible.

  • Get a list of those with whom we’ve shared information. You have the right to request a list of instances in which we have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided us with an Authorization. We will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list we will give you will include disclosures made in the last six years unless you request a shorter time. We will provide the list to you at no charge, but if you make more than one request in the same year, we will charge you a reasonable cost based fee for each additional request.

  • Get a copy of this privacy notice. You may request a paper copy of this notice at any time, even if you agreed to receive it electronically.

  • Choose someone to act for your child. If you are your child’s legal guardian or have medical power of attorney, you can exercise these rights on your child’s behalf.

  • File a complaint if you feel rights are violated. You can file a complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

  • Receive notice. If your health records are subject to a valid subpoena or court order, unless prohibited by law.

  • Authorize disclosure. You may authorize disclosure of your health records to third parties through written consent.

Our Uses and Disclosures

The following categories describe different ways that we use and disclose health information:

  •  Treatment. We use health information to provide, coordinate, or manage your child’s therapy services with doctors and other health care providers who care for you or your child. Disclosures for treatment purposes are not limited to the minimum necessary standard. Because other health care providers need access to the full record and/or full and complete information in order to provide quality care. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers and referrals of a patient for health care from one health care provider to another.

  • Practice Operations. We may use your child’s health information to support internal activities related to running the Practice, including scheduling, record keeping, quality improvement, and legal compliance.

  • Payment.  We may use and disclose information to bill and receive payment from health plans or other entities. This may include sharing important medical information including but not limited to patient treatment notes, evaluations, and referrals. 

Federal privacy rules (regulations) allow health care providers who have direct treatment relationships with the patient to use or disclose the patient’s personal health information without the patient’s written authorization, to carry out the health care provider’s own treatment, payment or health care operations. We may also disclose your protected health information for the treatment activities of any health care provider. This too can be done without your written authorization. For example, if a health care provider were to consult with another licensed health care provider about your condition, we would be permitted to use and disclose your personal health information, which is otherwise confidential, in order to assist the health care provider in diagnosis and treatment of your condition.

Certain Uses and Disclosures Do Not Require Your Authorization

Subject to certain limitations in the law, we can use and disclose your health information without your Authorization for the following reasons:

  • When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.

  • For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.

  • For health oversight activities (e.g., audits).

  • For judicial and administrative proceedings, including responding to a court or administrative order, although my preference is to obtain an Authorization from you before doing so.

  • For law enforcement purposes, including reporting crimes occurring on my premises.

  • To avoid serious threat to health or safety.

  • Appointment reminders and health related benefits or services. We may use and disclose your PHI to contact you to remind you that you have an appointment with us. We may also use and disclose your PHI to tell you about treatment alternatives, or other health care services or benefits that we offer.

  • With your written authorization for other uses (e.g., marketing)

Record Retention

We maintain your health records for a minimum of seven (7) years from the date of the last patient encounter, or if you are a minor, until you reach age 19 or for seven years, whichever is longer, in compliance with Minnesota law.

Minors' Rights

Minnesota law grants certain minors the right to consent to their own healthcare and control access to related health records, including services related to reproductive health, substance use treatment, and mental health care.

Lawsuits and Disputes 

If you are involved in a lawsuit, we may disclose health information in response to a court or administrative order. We may also disclose health information about your child in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Certain Uses and Disclosures Require You to Have the Opportunity to Object

We may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.

Our Responsibilities

We are required by law to:

  • Maintain the privacy and security of your child’s protected health information.

  • Provide you with this notice of our privacy practices and our legal duties with respect to health information.

  • In the event of a breach of your health records, we will notify you as required by both federal HIPAA regulations and Minnesota law (Minn. Stat. § 144.293, Subd. 2a).

  • Abide by the terms of this notice.

We reserve the right to update this notice at any time. Any changes will apply to all the information we maintain. The current notice will always be available upon request.

If you have any questions about this Privacy Policy, please contact:

Sara Azorsky Pediatric Therapy Services, LLC
Privacy Officer: Sara Azorsky, MS, CCC-SLP, CLC (sara@azorskypediatrictherapy.com)