Notice of Privacy Practices
Red Pine Neuropsychology, LLC
Effective Date: 09/16/2026
Your Information. Your Rights. Our Responsibilities.
This Notice describes how medical and psychological information about you may be used and disclosed, how you can obtain access to this information, and your rights regarding your health information.
Please review it carefully.
Our Commitment to Your Privacy
Red Pine Neuropsychology, LLC is committed to protecting the privacy and confidentiality of your health information.
We are required by the Health Insurance Portability and Accountability Act (HIPAA) and other applicable federal and state laws to:
Maintain the privacy and security of your protected health information (PHI).
Provide you with this Notice of Privacy Practices.
Follow the privacy practices described in the Notice currently in effect.
Notify you promptly if a breach occurs that may have compromised the privacy or security of your information.
Protected health information includes information that identifies you and relates to your physical or mental health, health care services, or payment for those services.
Your Rights
You have certain rights regarding your health information.
Inspect and Obtain Copies
You may ask to see or obtain an electronic or paper copy of your health record and other health information maintained about you.
We will generally provide a copy or summary within the time required by law. A reasonable, cost-based fee may apply when permitted by law.
Request Corrections
If you believe information in your record is incorrect or incomplete, you may ask us to correct it.
We may deny the request in certain circumstances, but if we do, we will explain why in writing as required by law.
Request Confidential Communications
You may ask us to contact you in a particular way, such as at a specific telephone number, or to send mail to a different address.
We will accommodate reasonable requests.
Request Restrictions
You may ask us not to use or disclose certain health information for treatment, payment, or health care operations.
We are generally not required to agree to such a request.
However, if you pay for a health care service in full out of pocket, you may ask us not to disclose information about that service to your health plan for payment or health care operations. We will honor that request unless disclosure is required by law.
Receive an Accounting of Disclosures
You may request a list, or accounting, of certain disclosures of your health information made during the six years preceding your request.
Certain disclosures are excluded from this accounting, including many disclosures related to treatment, payment, health care operations, and disclosures that you specifically authorized.
One accounting in a 12-month period will generally be provided without charge. A reasonable, cost-based fee may apply to additional requests during the same period.
Obtain a Copy of This Notice
You may request a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.
Choose Someone to Act for You
If another person has legal authority to act on your behalf, such as through a valid health care power of attorney or guardianship, that person may exercise your privacy rights as permitted by law.
We will verify that person's authority before acting on the person's behalf.
File a Complaint
If you believe your privacy rights have been violated, you may file a complaint with Red Pine Neuropsychology 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.
Red Pine Neuropsychology will not retaliate against you for filing a complaint.
Your Choices
In certain circumstances, you may tell us your preferences regarding how your health information is shared.
For example, you may tell us whether you want us to share relevant information with:
Family members
Close friends
Other individuals involved in your care
If you are unable to communicate your preference, we may share information when permitted by law if we believe doing so is in your best interest.
We may also disclose information when necessary and legally permitted to prevent or lessen a serious and imminent threat to health or safety.
Because Red Pine Neuropsychology provides psychological services in Utah, additional state-law protections may apply to confidential psychologist-patient communications, as described below.
How We May Use and Disclose Your Information
We may use or disclose protected health information as permitted by federal and state law.
Treatment
We may use your health information to provide psychological and neuropsychological assessment services and to coordinate your care.
Examples may include:
Reviewing medical records
Integrating information from other health care providers
Preparing evaluation reports
Communicating with another health care professional involved in your care when permitted by applicable law
Because Utah law provides additional confidentiality protections for communications between psychologists and their patients, written authorization may be required for certain disclosures that HIPAA alone would otherwise permit.
Payment
We may use and disclose information as necessary to obtain payment for services.
Examples may include:
Processing payments
Collecting outstanding balances
Providing receipts or invoices
Submitting claims or required information to Medicare or another health plan when applicable
Responding to health-plan requests relating to payment or coverage when permitted by law
Red Pine Neuropsychology provides both private-pay services and, when applicable, services that may be billed to participating health plans.
Health Care Operations
We may use and disclose health information as permitted by law for activities necessary to operate the practice, such as:
Quality improvement
Professional consultation
Credentialing
Compliance activities
Auditing
Business management
Practice administration
Improving services
Business associates who perform services on behalf of Red Pine Neuropsychology—such as electronic health record providers, payment processors, secure technology vendors, or cloud-service providers—are required to safeguard protected health information in accordance with applicable law and contractual requirements.
Other Uses and Disclosures Permitted or Required by Law
We may use or disclose health information without your authorization when permitted or required by applicable law.
Examples may include:
Public Health and Safety
We may disclose information when legally permitted or required for purposes such as:
Reporting suspected abuse, neglect, or exploitation
Public-health reporting
Reporting certain communicable diseases
Preventing or reducing a serious threat to health or safety
Health Oversight
We may disclose information to health oversight agencies for activities authorized by law, such as licensing, audits, investigations, or inspections.
Judicial and Administrative Proceedings
Information may be disclosed pursuant to valid legal process when permitted or required by applicable state and federal law.
Law Enforcement
We may disclose information for certain law-enforcement purposes when permitted or required by law.
Workers' Compensation
We may disclose information as authorized by workers' compensation laws or similar programs.
Coroners, Medical Examiners, and Funeral Directors
Information may be disclosed when authorized or required by law for these purposes.
Government Functions
Information may be disclosed for certain legally authorized governmental activities.
When Required by Law
We will disclose information when federal or state law requires us to do so.
Additional Protections Under Utah Law
Utah law provides specific confidentiality protections for communications between psychologists and their clients or patients.
In general, a Utah psychologist may not disclose a confidential communication with a patient without the patient's express written consent, except when disclosure is permitted or required by state or federal law, rule, regulation, or order; is authorized under an applicable evidentiary-privilege exception; or is authorized or required by a generally recognized professional or ethical standard.
These protections may be more restrictive than HIPAA in certain circumstances. When applicable law provides greater privacy protection than HIPAA, Red Pine Neuropsychology will follow the more protective requirements.
Uses and Disclosures Requiring Written Authorization
We will obtain your written authorization before using or disclosing your health information when authorization is required by law.
Examples may include:
Releasing evaluation reports to employers
Sending reports to attorneys
Disclosing information to schools or universities
Certain disclosures to family members or other third parties
Most uses or disclosures of psychotherapy notes, if such notes exist
Most marketing uses
Sale of protected health information
Other disclosures not otherwise permitted by law
You may revoke an authorization in writing at any time, except to the extent that we have already acted in reliance on it.
Psychotherapy Notes
Psychotherapy notes receive additional protections under HIPAA.
Red Pine Neuropsychology primarily provides assessment services rather than ongoing psychotherapy. If psychotherapy notes are created and maintained separately from the remainder of the clinical record, most uses or disclosures of those notes require written authorization except where otherwise permitted or required by law.
Substance Use Disorder Records
Certain substance use disorder records are subject to additional federal confidentiality protections under 42 CFR Part 2.
To the extent Red Pine Neuropsychology creates or maintains substance use disorder patient records that are subject to Part 2, those records will be handled in accordance with applicable federal law.
Information contained in a substance use disorder patient record subject to 42 CFR Part 2 generally may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you without your written consent or an appropriate court order and subpoena as required by law.
Additional restrictions may apply to the use and disclosure of Part 2 records.
Electronic Communication
If you choose to communicate with Red Pine Neuropsychology by email, text message, or another electronic method, reasonable safeguards will be used where appropriate.
However, electronic communications may involve privacy and security risks.
Sensitive clinical information should be communicated through the secure patient portal whenever possible.
Electronic communication should not be used for emergencies.
Audio Recordings and Clinical Documentation
If you consent to audio recording of a clinical interview, the recording may be used for clinical documentation and report preparation.
Recordings will be maintained securely and retained only as long as clinically necessary or otherwise required by applicable law or practice policy.
HIPAA-compliant technology, including secure documentation tools, may be used to assist with clinical documentation.
These technologies do not replace the psychologist's independent professional judgment.
Our Responsibilities
Red Pine Neuropsychology is required to:
Maintain the privacy and security of your protected health information.
Notify you promptly if a breach occurs that may have compromised the privacy or security of your information.
Follow the duties and privacy practices described in this Notice.
Provide you with a copy of this Notice upon request.
We will not use or disclose your information other than as described in this Notice unless you authorize us to do so in writing or the use or disclosure is otherwise permitted or required by law.
If you provide authorization, you may revoke it in writing at any time, except to the extent that we have already acted in reliance on it.
Changes to This Notice
Red Pine Neuropsychology may change the terms of this Notice.
Changes may apply to all protected health information maintained by the practice, including information created or received before the change.
The current version of the Notice will be available:
On request
At the practice
On the Red Pine Neuropsychology website
The Notice will identify its effective date.
Questions or Complaints
If you have questions about this Notice, would like to exercise your privacy rights, or believe your privacy rights have been violated, please contact:
Privacy Contact: Jared Cline, PhD
Red Pine Neuropsychology, LLC
775 N 1525 W STE 213
Farmington, UT 84025-4815
Phone: (801) 923-8345
Fax: (888) 355-0195
Email: info@redpineneuro.com
Website: www.redpineneuro.com
You may also file a complaint with:
U.S. Department of Health and Human Services Office for Civil Rights
You can obtain information about filing a complaint through the U.S. Department of Health and Human Services.
Red Pine Neuropsychology will not retaliate against you for filing a complaint.