Privacy STatement

35% off when you mention code FIRSTVISIT


Effective April 14, 2003, Little Peace of Hafen llc. is required by law to maintain the privacy of your medical information, provide this notice to you, and abide by the terms of this notice.

How We Use Your Health Information

When you receive care from Little Peace of Hafen, we may use your health information for treating you, billing for services, and conducting our normal business known as health care operations. Examples of how we use your information include:


We keep records of the care and services provided to you. Health care providers use these records to deliver quality care to meet your needs. For example, your therapist may share your health information with another practitioner who will assist in your treatment. Some health records, including confidential communications with other mental health professionals or substance abuse treatment records may have additional restrictions for use and disclosure under state and federal laws.


We keep billing records that include payment information and documentation of the services provided to you. Your information may be used to obtain payment from you or other third party payers. We may also contact your third party payer to verify coverage for your care or to notify them of upcoming services that may need prior notice or approval. For example, we may disclose information about the services provided to you to claim and obtain payment from your third party payer. If you pay full cash price for services, you may request a restriction of information to your third party payer.

Health Care Options

We use health information to improve the quality of care, train staff and students, provide customer service, manage costs, conduct required business duties, and make plans to better serve our communities. For example, we may use your health information to evaluate the quality of treatment and services provided by our therapists, psychiatrists, psychologists, case managers, and other health care workers.

Other Services We Provide

We may also use your health information to recommend treatment alternatives, tell you about health services and products that may benefit you, share information with family and friends involved in your care (authorized by you through a written release), share information with third parties who assist us with treatment, payment, and health care operation, and remind you of an appointment. By signing the acknowledgement form that you received this form, you authorize us to view your medication history.

Your Individual Rights

You have the right to:

All other uses and disclosers, not described in this notice, require your signed authorization. You may revoke your authorization at any time with the written statement. The following are examples:

Our Privacy Responsibilities

Little Peace of Hafen, llc., is required by law to:

Contact Us

If you would like further information about your privacy rights, are concerned that your privacy rights have been violated, or disagree with a decision that we made about access toyour health information please email Little Peace of Hafen at or visit our office 459 E 1000 S Pleasant Grove, 84062 . We will investigate all complaints and will not retaliate against you for filing a complaint. You may also file a written complaint with the Office of Civil Rights, 200 Independence Avenue, S.W. Room 509F HHH Bldg., Washington, D.C. 20201.