Notice of Privacy Practices

Effective September 11, 2026

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, HOW YOU CAN GET ACCESS TO THIS INFORMATION, AND YOUR PRIVACY RIGHTS. PLEASE REVIEW IT CAREFULLY.

Privacy Contact: Kimberly Buhay Gibu | (808) 202-2855 | support@gbintegrativepsychiatry.com

928 Nuʻuanu Avenue, Honolulu, Hawaiʻi 96817

Your Rights

• Get an electronic or paper copy of your medical record and other health information maintained in our designated record set, subject to lawful exceptions.

• Ask us to correct health information you believe is incorrect or incomplete.

• Ask us to contact you in a specific way or at a different address. We will accommodate reasonable requests.

• Ask us to limit certain uses or disclosures. We are not required to agree to every request. If you pay in full out of pocket for a service, you may ask us not to share information about that service with your health plan for payment or health-care operations, and we will honor the request unless disclosure is required by law.

• Ask for an accounting of certain disclosures made during the period permitted by law.

• Get a paper copy of this Notice at any time.

• Choose a personal representative or other person legally authorized to act for you.

• File a complaint if you believe your privacy rights were violated. G&B will not retaliate against you for filing a complaint.

We provide access within the time required by applicable law. HIPAA generally requires action on an access request within 30 days. Hawaiʻi law may impose a shorter or different requirement for a particular request, including certain attorney-authorized record requests; when it does, G&B follows the applicable requirement.

Your Choices

For certain health information, you may tell us your preferences about what we share. Where applicable, you may direct or limit disclosure to family members, close friends, or others involved in your care or payment for your care, and you may state preferences regarding disaster-relief disclosures. If you cannot tell us your preference, we may act in your best interests when the law permits.

We will obtain your written authorization before using or disclosing protected health information for marketing when authorization is required, before selling protected health information, and for most uses or disclosures of HIPAA-defined psychotherapy notes. You may revoke an authorization in writing as permitted by law.

G&B does not maintain a hospital directory and does not currently use patient protected health information for fundraising. If those practices change, we will follow applicable notice, authorization, and opt-out requirements.

How We Typically Use or Share Health Information

Treatment

We may use and share your health information with other professionals who are treating you or otherwise participating lawfully in your care.

Health-Care Operations

We may use and share your health information to operate the practice, improve care, conduct quality assessment, credential clinicians, perform compliance and auditing functions, train staff, obtain legal or accounting services, and contact you when necessary.

Payment

We may use and share your health information to bill and obtain payment from you, a health plan, or another responsible payer, including eligibility, authorization, claims, utilization review, and collection activities permitted by law.

Other Uses and Disclosures Permitted or Required by Law

Subject to the conditions imposed by applicable law, we may use or disclose health information for public-health and safety activities; research; compliance with law; organ and tissue donation; coroners, medical examiners, and funeral directors; workers' compensation; health oversight; law enforcement and other government functions; and judicial or administrative proceedings.

Substance Use Disorder Records Protected by 42 CFR Part 2

To the extent G&B has substance use disorder patient records protected by 42 CFR Part 2, we will apply the additional protections required by Part 2. We will not use or disclose Part 2 records in a civil, criminal, administrative, or legislative investigation or proceeding against you unless you give written consent for that use or disclosure or a court order and subpoena satisfy Part 2's requirements.

If G&B itself becomes a Part 2 program, G&B will provide the Part 2 patient notice required by federal law, either separately or in a legally compliant combined notice.

Mental-Health Records and Psychotherapy Notes

Ordinary psychiatric progress notes, diagnoses, medication information, treatment plans, symptoms, functional status, prognosis, and progress information are generally part of the medical record. HIPAA-defined psychotherapy notes are a narrower category of notes documenting or analyzing the contents of counseling sessions that are maintained separately from the medical record. If G&B creates such notes, they receive the special protections required by law.

Hawaiʻi law may provide confidentiality or privilege protections in addition to HIPAA for particular mental-health information or proceedings. G&B follows any applicable state law that provides greater protection or imposes additional conditions on disclosure.

Minors and Personal Representatives

Rights concerning a minor's health information depend on who has legal authority to consent to the particular care and on applicable Hawaiʻi and federal law. When Hawaiʻi law permits a minor to consent independently to qualifying care, the minor may control some related confidentiality and record-access rights. G&B determines these rights from governing law and documentation rather than assuming that every parent or guardian is entitled to every portion of a minor's record.

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.

• We will notify you as required if a breach occurs that may have compromised the privacy or security of your information.

• We must follow the duties and privacy practices described in the Notice currently in effect and give you a copy of this Notice.

• We will not use or disclose your information other than as described in this Notice unless you authorize us in writing or another law permits or requires the use or disclosure.

Complaints and Questions

For questions, requests, or complaints, contact Kimberly Buhay Gibu at (808) 202-2855 or support@gbintegrativepsychiatry.com. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. G&B will not retaliate against you for filing a complaint.

Changes to This Notice

G&B may change the terms of this Notice, and a revised Notice may apply to all protected health information maintained by the practice. The current Notice will be available upon request, at the practice location, and on G&B's website.