Notice of Privacy Practices (rev 2026-10-20) Pelaez and Beyond Professional Corp Applies to: Pelaez and Beyond Professional Corp. Applied Behavior Analysis (ABA) services. THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. Effective date: November 1, 2026 In this notice, "you" means the client. Most of the people we serve are children. A parent, legal guardian, or other personal representative usually exercises these rights for the child, as allowed by law. OUR DUTIES We are required by law to keep your protected health information (PHI) private, to give you this notice of our legal duties and privacy practices, to follow the notice currently in effect, and to notify you if a breach of your unsecured PHI occurs. We may change this notice; changes will apply to all information we have. The new notice will be available on request, in our office, and on our website. YOUR RIGHTS Get a copy of your record: You can ask to see or get an electronic or paper copy of your record. We will respond within 30 days and may charge a reasonable, cost-based fee. Ask us to correct your record: You can ask us to correct information you think is wrong or incomplete. We may say no, but we will tell you why in writing within 60 days. Request confidential communications: You can ask us to contact you in a specific way (for example, a certain phone number) or at a different address. We will say yes to all reasonable requests. Ask us to limit what we use or share: You can ask us not to use or share certain information for treatment, payment or operations. We are not required to agree. If you pay for a service in full out of pocket, you can ask us not to share that information with your health insurer for payment or operations; we will say yes unless a law requires us to share it. Get a list of disclosures: You can ask for a list of the times we shared your information in the six years before your request, who we shared it with, and why (excluding treatment, payment, operations and certain other disclosures). One list per year is free. Get a paper copy of this notice at any time, even if you agreed to receive it electronically. Choose someone to act for you: A legal guardian or person with medical power of attorney can exercise your rights. We will confirm their authority first. File a complaint: Contact our Privacy Officer (below), or the U.S. Department of Health and Human Services Office for Civil Rights, 200 Independence Avenue S.W., Washington, D.C. 20201, 1-877-696-6775, www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint. YOUR CHOICES You can tell us whether to share information with family, close friends or others involved in your care, or in a disaster relief situation. If you cannot tell us (for example, in an emergency), we may share if we believe it is in your best interest, or to lessen a serious and imminent threat to health or safety. We never share your information for marketing or sell your information without your written permission. Psychotherapy notes, if any exist, are not shared without your written authorization except as the law allows. HOW WE USE AND SHARE YOUR INFORMATION Treatment: We use and share information with the professionals treating your child (for example, the BCBA, RBTs, your child's doctor). Payment: We use and share information to bill and get payment from health plans, including Florida Medicaid and Medicaid health plans where applicable. Health care operations: We use information to run our practice, improve care, train staff, and for audits and compliance. Business associates: We share information with companies that perform services for us (for example, billing or our electronic record system) under written agreements that require them to protect it. We may also share information without your authorization when the law allows or requires it, including: To report suspected child abuse, neglect, or exploitation to the Florida Abuse Hotline (Florida Department of Children and Families) and as required by s. 39.201, F.S. To prevent a serious threat to health or safety. For health oversight activities, such as audits and investigations by the Agency for Health Care Administration (AHCA) or other oversight agencies. To comply with the law, including requests from the U.S. Department of Health and Human Services. In response to a court or administrative order, subpoena, or other lawful process, as limited by 45 CFR 164.512(e). For law enforcement purposes, public health activities, workers' compensation, and specialized government functions, as allowed by law. To coroners, medical examiners or funeral directors when a client dies. Other uses: Any other use or disclosure requires your written authorization. You may revoke an authorization in writing at any time, except to the extent we already acted on it. Information from a school record or substance use disorder treatment program may have additional protections under other federal law (FERPA, 42 CFR Part 2). CONTACT US / PRIVACY OFFICER Pelaez and Beyond Professional Corp, Attn: Privacy Officer Privacy Officer: Amber, COO - [email protected] - 888-872-0459 Address: 3000 Oasis Grand Blvd, Apt 1805, Fort Myers, FL 33916 Intake phone: 888-872-0459 Fax: 888-391-5328 Website (where this notice is posted): pbpbehavior.org