Your information and this practice
This notice explains how the practice may use and share your health information, how you can access it, and how to raise a privacy concern. Please read it carefully.
It applies to the records maintained by Jeffrey Panko, PMHNP-BC, practicing as thoughtscape NP Psychiatry. Your privacy contact is Jeffrey Panko: JMPankoNP@thoughtscapeNP.com or 646-549-4694. Contact the practice for request instructions or a paper copy.
Your rights
- Access records. Ask to inspect or receive paper or electronic copies of your medical and billing records. Requests are generally completed within 30 days, subject to a legally permitted extension and any shorter applicable deadline. A permitted, reasonable copying fee may apply; unpaid treatment bills do not prevent access. Certain records, including separately maintained psychotherapy notes, are excluded. If access is denied, you will receive an explanation and applicable review rights.
- Request a correction. Explain in writing what you believe is inaccurate or incomplete. A decision is generally provided within 60 days, subject to a permitted extension. If a request is denied, you may submit a statement of disagreement for the record.
- Choose confidential contact. Ask to be contacted through a particular number or at another address. The practice will accommodate reasonable requests.
- Request limits. You may ask to restrict uses or disclosures. The practice need not agree to every request. If you pay for a service in full yourself and request it, information about that service will not be disclosed to your health plan for payment or operations unless disclosure is required by law.
- Request an accounting. Ask for a list of certain disclosures during the preceding six years. This does not include every disclosure; treatment, payment, operations, and other exceptions generally are excluded. One accounting in a 12-month period is free.
- Receive this notice. You may request a paper copy even if you agreed to electronic delivery.
- Use a representative. A person with valid legal authority may exercise rights on your behalf after the practice verifies that authority.
Treatment, payment, and practice operations
As permitted by law, information may be used or shared to provide care, obtain payment, and run the practice. Examples include discussing medication with a treating clinician or pharmacist, submitting a claim to your health plan, arranging follow-up, reviewing quality, and maintaining records. Providers who assist with these functions must protect information as required by applicable law and agreements. Additional protections described below still apply.
Your choices and written permission
You can tell the practice whether to share relevant information with family, friends, or others involved in your care or payment. When you cannot express a preference, limited sharing may be permitted in your best interests or to address a serious, imminent threat.
Uses outside this notice generally require written authorization. Most disclosures of separately maintained psychotherapy notes, marketing uses requiring authorization, and sale of protected health information require written permission. The practice does not sell your health information. You may revoke an authorization in writing; revocation does not undo actions already taken in reliance on it.
If the practice conducts fundraising, you may opt out of further fundraising contact. Any use of protected substance use disorder records for fundraising requires advance notice and the choice required by Part 2.
Other uses permitted or required by law
Subject to legal conditions, information may be disclosed for public health reporting; medication safety; suspected abuse or neglect; a serious threat to health or safety; health oversight; legally authorized research; workers’ compensation; certain law enforcement or government functions; organ donation; or a coroner, medical examiner, or funeral director. Information may also be disclosed when required by law or in response to a legally sufficient court or administrative process. A request alone does not automatically permit disclosure; applicable protections and required procedures must be met.
Additional protections
More protective state or federal rules take priority. New York law limits disclosure of confidential HIV-related information to authorized recipients and specified circumstances, often requiring a specific written release. Where additional protections apply to mental health or other sensitive records, the practice follows those requirements rather than relying only on HIPAA’s general permissions.
If the practice receives substance use disorder records protected by 42 CFR Part 2, those protections continue to apply. Such records will not be used or disclosed in civil, criminal, administrative, or legislative proceedings or investigations against you without your written consent or a qualifying court order and subpoena. These limits apply even to the disclosure categories described above. The practice will obtain consent when required and honor applicable restrictions on redisclosure.
Practice responsibilities and changes
The practice must safeguard protected health information, follow the privacy duties described in this notice, provide this notice, and notify you as required if a breach of unsecured protected health information occurs. Information will not be used or shared beyond applicable permissions without the required authorization.
The practice may revise this notice and apply revised terms to information already held as well as future records, as permitted by law. A dated, updated notice will be posted here and available on request. This website notice does not replace providing the notice during intake.
Questions, requests, and complaints
Contact Jeffrey Panko at JMPankoNP@thoughtscapeNP.com or 646-549-4694. You may also complain directly to the U.S. Department of Health and Human Services Office for Civil Rights. The practice will not retaliate against you for filing a complaint or exercising your rights.
Further information: HHS: your health information privacy rights.