Notice of Privacy Practices

MR. L’S TUTORING AND ENRICHMENT LLC
NOTICE OF PRIVACY PRACTICES
Effective Date: 6/15/2025

This Notice describes how your health information may be used and disclosed and how you can access this information. Please review it carefully. Your privacy is important to us.

1. Our Responsibilities

MR. L’s Tutoring and Enrichment LLC is committed to protecting your child’s health information. We are required by law to:

• Maintain the privacy of your protected health information (PHI)

• Provide you with this Notice of our legal duties and privacy practices

• Follow the terms of this Notice

• Notify you if a breach occurs that may have compromised the privacy or security of your information

2. How We May Use and Disclose Health Information

We may use and share your health information in the following ways:

For Treatment:
We may use your child’s health information to provide ABA therapy services, treatment planning, consultations, and coordination with other providers or caregivers.

For Payment:
We may use or share information with your health insurance plan to receive payment for services rendered, to determine coverage, or to bill for services. This may include sharing service dates, diagnosis codes, and documentation required by insurers.

For Health Care Operations:
We may use your information for internal quality review, staff supervision, licensing, audits, training, and business management purposes.

3. Disclosures That Require Your Written Authorization

We will not share your or your child’s health information for the following purposes unless you give us written permission:

• Marketing or promotional communications

• Release to schools, camps, or other third-party agencies (unless clinically necessary)

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

4. Other Permitted or Required Disclosures

We may also share information without your written authorization in limited cases as required by law, including:

• If required by a court order or subpoena

• For mandated reporting of abuse or neglect

• To prevent or reduce a serious threat to health or safety

• To comply with public health laws (e.g., disease prevention)

5. Your Rights Regarding Health Information

You have the right to:

• Request a copy of your records: You may request to inspect or receive a paper or electronic copy of your child’s treatment record. Requests must be made in writing.

• Request corrections: You may ask us to correct your child’s health information if you believe it is incomplete or inaccurate.

• Request confidential communications: You may ask us to contact you in a specific way (e.g., home phone, email) or to send mail to a different address.

• Limit what we use or share: You can ask us not to share certain health information. We are not required to agree to your request, but we will comply when legally and ethically feasible.

• Get a list of disclosures: You may request an accounting of certain disclosures we made of your information in the past six years.

To exercise these rights, please submit your request in writing to:
MR. L’s Tutoring and Enrichment LLC
304 Cummins Highway
Roslindale, MA 02131
Email: admin@tutorwithmrl.com
Phone: (617) 750-0184

6. Complaints

If you believe your privacy rights have been violated, you may file a complaint with our office or with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

To file a complaint with MR. L’s Tutoring and Enrichment LLC, contact:
Privacy Officer
Email: info@tutorwithmrl.com

7. Changes to This Notice

We reserve the right to change this Notice at any time. The revised Notice will apply to all information we have about you and your child. The current version will always be available upon request and on our website.

8. Acknowledgment of Receipt

You will be asked to sign a separate acknowledgment form stating that you have received and reviewed this Notice.