HIPAA Notice of Privacy Practices HIPAA Notice of Privacy Practices NOTICE: I keep a record of the health care services I provide you. You may ask me to see and copy that record. You may also ask me to correct that record. I will not disclose your record to others unless you direct me to do so or unless the law authorizes or compels me to do so. You may see your record or get more information about it at Sign In Psychiatric, PLLC, PO Box 2283, Kirkland, WA 98083. 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. Your health record contains personal information about you and your health. State and Federal law protects the confidentiality of this information. Protected Health Information (PHI) is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical and mental health, or condition, and related health care services. If you suspect a violation of these legal protections, you may file a report to the appropriate authorities in accordance with Federal and State regulations. I am required by law to maintain the privacy of your PHI and to provide you with notice of my legal duties and privacy practices with respect to your PHI. This Notice of Privacy Practices describes how I may use and disclose your PHI in accordance with all applicable law. It also describes your rights regarding how you may gain access to and control your PHI. I am required by law to maintain the privacy of PHI and to provide you with notice of my legal duties and privacy practices with respect to PHI. I am required to abide by the terms of this Notice of Privacy Practices. I reserve the right to change the terms of my Notice of Privacy Practices at any time. Any new Notice of Privacy Practices will be effective for all PHI that I maintain at that time. I will make available a revised Notice of Privacy Practices by sending you an electronic copy, sending a copy to you in the mail upon your request, or providing one to you in person. How I am permitted to Use and Disclose Your PHI For Treatment. I may use medical and clinical information about you to provide you with treatment services. For Payment. I may use and disclose medical information about you so that I can receive payment for the treatment services provided to you. For Healthcare Operations. I may use and disclose your protected PHI for certain purposes in connection with the operation of my professional practice, including supervision and consultation. Without Your Authorization. State and Federal law also permits me to disclose information about you without your authorization in a limited number of situations, such as with a court order. With Authorization. I must obtain written authorization from you for other uses and disclosures of your PHI. You may revoke such authorizations in writing in accordance with 45 CFR. 164.508(b)(5). Incidental Use and Disclosure. I am not required to eliminate every risk of an incidental use or disclosure of your PHI. Specifically, a use or disclosure of your PHI that occurs as a result of, or incident to an otherwise permitted use or disclosure is permitted as long as I have adopted reasonable safeguards to protect your PHI, and the information being shared was limited to the minimum necessary. Examples of How I May Use and Disclose Your PHI Listed below are examples of the uses and disclosures that I may make of your PHI. These examples are not meant to be a complete list of all possible disclosures, rather, they are illustrative of the types of uses and disclosures that may be made. Treatment. Your PHI may be used and disclosed by me for the purpose of providing, coordinating, or managing your health care treatment and any related services. This may include coordination or management of your health care with a third party, consultation or supervision activities with other health care providers, or referral to another provider for health care services. Payment. I may use your PHI to obtain payment for your health care services. This may include providing information to a third party payor, or, in the case of unpaid fees, submitting your name and amount owed to a collection agency. Healthcare Operations. I may use or disclose your PHI in order to support the business activities of my professional practice including; disclosures to others for health care education, or to provide planning, quality assurance, peer review, or administrative, legal, financial, or actuarial services to assist in the delivery of health care, provided I have a written contract with the business that prohibits it from re-disclosing your PHI and requires it to safeguard the privacy of your PHI. I may also contact you to remind you of your appointments. Other Uses and Disclosures That Do Not Require Your Authorization Required by Law. I may use or disclose your PHI to the extent that the use or disclosure is required by law, made in compliance with the law, and limited to the relevant requirements of the law. Examples of this type of disclosure include healthcare licensure related reports, public health reports, and law enforcement reports. Under the law, I must make certain disclosures of your PHI to you upon your request. In addition, I must make disclosures to the US Secretary of the Department of Health and Human Services for the purpose of investigating or determining my compliance with the requirements of privacy rules. Health Oversight. I may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies and organizations that provide financial assistance to the program (such as third-party payors) and peer review organizations performing utilization and quality control. If I disclose PHI to a health oversight agency, I will have an agreement in place that requires the agency to safeguard the privacy of your information. Abuse or Neglect. I may disclose your PHI to a state or local agency that is authorized by law to receive reports of abuse or neglect. However, the information I disclose is limited to only that information which is necessary to make the required mandated report. Deceased Clients. I may disclose PHI regarding deceased clients for the purpose of determining the cause of death, in connection with laws requiring the collection of death or other vital statistics, or permitting inquiry into the cause of death. Research. I may disclose PHI to researchers if (a) an Institutional Review Board reviews and approves the research and a waiver to the authorization requirement; (b) the researchers establish protocols to ensure the privacy of your PHI; and (c) the researchers agree to maintain the security of your PHI in accordance with applicable laws and regulations. Criminal Activity or Threats to Personal Safety. I may disclose your PHI to law enforcement officials if I believe that disclosure of confidential information is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. Compulsory Process. I may be required to disclose your PHI if a court of competent jurisdiction issues an appropriate order, and if the rule of privilege has been determined not to apply. I may be required to disclose your PHI if I have been notified in writing at least fourteen days in advance of a subpoena or other legal demand, no protective order has been obtained, and a competent judicial officer has determined that the rule of privilege does not apply. Essential Government Functions. I may be required to disclose your PHI for certain essential government functions. Such functions include: assuring proper execution of a military mission, conducting intelligence and national security activities that are authorized by law, providing protective services to the President, making medical suitability determinations for U.S. State Department employees, protecting the health and safety of inmates or employees in a correctional institution, and determining eligibility for or conducting enrollment in certain government benefit programs. Law Enforcement Purposes. I may be authorized to disclose your PHI to law enforcement officials for law enforcement purposes under the following circumstances, and subject to specified conditions: as required by law (including court orders, court-ordered warrants, subpoenas) and administrative requests; to identify or locate a suspect, fugitive, material witness, or missing person; in response to a law enforcement official’s request for information about a victim or suspected victim of a crime; to alert law enforcement of a person’s death, if I suspect that criminal activity caused the death; when I believe that protected health information is evidence of a crime that occurred on my premises; if I believe that disclosure of confidential information is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public; and in a medical emergency not occurring on my premises, when necessary to inform law enforcement about the commission and nature of a crime, the location of the crime or crime victims, and the perpetrator of the crime. Psychotherapy Notes. If kept as separate records, I must obtain your authorization to use or disclose psychotherapy notes with the following exceptions. I may use the notes for your treatment. I may also use or disclose, without your authorization, the psychotherapy notes for my own training, to defend myself in legal or administrative proceedings initiated by you, as required by the Washington Department of Health or the US Department of Health and Human Services to investigate or determine my compliance with applicable regulations, to avoid or minimize an imminent threat to anyone’s health or safety, to a health oversight agency for lawful oversight, for the lawful activities of a coroner or medical examiner, as otherwise required by law, or with a valid court order. Uses and Disclosures of PHI With Your Written Authorization Other uses and disclosures of your PHI will be made only with your written authorization. I will not make any other uses or disclosures of your psychotherapy notes, I will not use or disclose your PHI for marketing purposes, and I will not sell your PHI without your authorization. You may revoke your authorization in writing at any time. Such revocation of authorization will not be effective for actions I may have taken in reliance on your authorization of the use or disclosure. Your Rights Regarding Your PHI You have the following rights regarding PHI that I maintain about you. Any requests with respect to these rights must be in writing. A brief description of how you may exercise these rights is included. Right of Access to Inspect and Copy. You may inspect and obtain a copy of your PHI that is contained in a designated record set for as long as I maintain the record. A "designated record set" contains medical and billing records and any other records that I use for making decisions about you. Your request must be in writing. I may charge you a reasonable cost-based fee for the copying and transmitting of your PHI. I can deny you access to your PHI in certain circumstances. In some of those cases, you will have a right of recourse to the denial of access. Please contact me if you have questions about access to your medical record. Right to Amend. You may request, in writing, that I amend your PHI that has been included in a designated record set. In certain cases, I may deny your request for an amendment. If I deny your request for amendment, you have the right to file a statement of disagreement with me. I may prepare a rebuttal to your statement and will provide you with a copy of any such rebuttal. Right to an Accounting of Disclosures. You may request an accounting of disclosures made for treatment purposes or made as a result of your authorization, for a period of up to six years, excluding disclosures made to you. I may charge you a reasonable fee if you request more than one accounting in any 12-month period. Please contact me if you have questions about accounting of disclosures. Right to Request Restrictions. You have the right to ask me not to use or disclose any part of your PHI for treatment, payment or health care operations or to family members involved in your care. Your request for restrictions must be in writing and I am not required to agree to such restrictions. Please contact me if you would like to request restrictions on the disclosure of your PHI. You also have the right to restrict certain disclosures of your PHI to your health plan if you pay out of pocket in full for the health care I provide to you. Right to Request Confidential Communication. You have the right to request to receive confidential communications from me by alternative means or at an alternative location. I will accommodate reasonable written requests. I may also condition this accommodation by asking you for information regarding how payment will be handled or specification of an alternative address or other method of contact. Please contact me if you would like to make this request. Right to a Copy of this Notice. You have the right to obtain a copy of this notice from me. Any questions you have about the contents of this document should be directed to me. Right to Opt Out. You have the right to choose not to receive fundraising communications. However, I will not contact you for fundraising purposes. Right to Notice of Breach. You have the right to be notified of any breach of your unsecured PHI. Contact Information I act as my own Privacy and Security Officer. If you have any questions about this Notice of Privacy Practices, please contact me. My contact information is: Patricia Greim, MS, ARNP, PMHNP-BC Sign In Psychiatric, PLLC PO Box 2283 Kirkland, WA 98038 (425) 246-3740 Complaints If you believe I have violated your privacy rights, you may file a complaint in writing with me, as my own Privacy Officer, as specified above. You also have the right to file a complaint in writing to the Washington Department of Health or to the US Secretary of Health and Human Services. I will not retaliate against you in any way for filing a complaint. Effective Date Effective date of this notice: June 24, 2024

Privacy Policy A legal disclaimer Website Privacy Statement This Privacy Statement sets forth the information gathering, use, and dissemination practices of Sign In Psychiatric, PLLC and/or its affiliates, partners, and assigns, ("SIP") in connection with the World Wide Web site located at www.oursignin.com , and any affiliated subpages ("Site"). This Privacy Statement applies solely to information SIP learns about you or obtains from you when you visit SIP’s Site. This Privacy Statement does not address or govern any information gathering, use, or dissemination practices related to information collected in any other way. This Privacy Statement does not address or govern the collection, maintenance, use, or disclosure of any private health information. Additional information about your rights with respect to your private health information is available in the HIPAA disclosure statement available at www.oursignin.com or directly from SIP. SIP can be contacted by mail at PO Box 2283, Kirkland WA 98033, by phone at (727) 501-4217, or by e-mail at office@oursignin.sprucecare.com . Your access or use of the Site constitutes your legally binding acceptance of, and agreement to, this Privacy Statement. This Privacy Statement may be changed at any time. It is your obligation as a user visiting the Site to familiarize yourself with this Privacy Statement. Any change to this Privacy Statement shall also be effective as to any visitor who has visited the Site before the change was made. 1. Collection of Personal Information from Site Visitors SIP may collect or track: The home server domain names, e-mail addresses, type of client computer, files downloaded, search engine used, operating system, and type of web browser of visitors to the Site, Your e-mail addresses if you communicate with SIP via e-mail, Information you knowingly provide in online forms, registration forms, surveys, e-mail, and other online avenues (including, without limitation, demographic and personal profile data), and Aggregate and user-specific information regarding which pages Site visitors access. In addition to information you provide, SIP may collect the name of the domain and host from which you access the internet; the IP address of the computer you are using; and the browser and operating system you are using; the date and time you accessed the Site; and the internet address of the web site from which you linked to the Site. SIP may place internet "cookies" on visitors' hard drives. Internet cookies can save data about individual visitors, such as the visitor's name, user-name, and the pages of a site viewed by the visitor. When the visitor revisits the Site, the Site may recognize the visitor by the internet cookie and customize the visitor's experience accordingly. Visitors may disable internet cookies, if any, by using the appropriate feature of their web client software, if available. When a visitor performs a search within the Site, SIP may record information identifying the visitor or linking the visitor to the search performed. SIP may also record limited information for every search request and use that information to solve technical problems with the services available directly or indirectly in connection with the Site and to calculate overall usage statistics. 2. Use of Personal Data Collected Personal data collected by SIP may be used by us for many reasons. Examples may include, editorial and feedback purposes, for marketing and promotional purposes, for a statistical analysis of users' behavior, for service development, for content improvement, for fulfillment of a requested transaction or recordkeeping, or to customize the content and layout of the Site. Aggregate data on visitors' home servers may be used for internal purposes, and individually identifying information, such as names, postal and e-mail addresses, phone numbers, and other personal information which visitors voluntarily provide to SIP may be added to SIP’s databases and used for future contact, mailings, and e-mail communications regarding Site updates, news, new services, and upcoming events. SIP may also use Site visitor data to contact the Site visitors regarding account status and changes to the submissions agreement, privacy statement, and any other policies or agreements relevant to Site visitors. 3. Disclosure of Personal Data to Third Parties SIP will not generally disclose any personally identifiable information to third parties. Notwithstanding the foregoing, SIP may disclose or distribute identifiable or non-identifiable data to a third party under certain situations including: As necessary for the conduct of normal business. For example, SIP may disclose your personally identifiable information in connections with bill payment by a third party. As required by law. For example, SIP may disclose your personally identifiable information to a third party pursuant to a valid subpoena, court order, or other form of legal process. As determined by SIP in its sole judgment that disclosure or distribution is appropriate to protect the life, health, or property of SIP or any other person or entity. For example, SIP may disclose your personally identifiable information in response to a request by or on behalf of any local, state, federal, or other government agency, department, or body, whether or not pursuant to a subpoena, court order, or other form of legal process. While SIP may undertake efforts to ensure that such third parties use the personal data solely for the purposes for which the data was disclosed, SIP is not responsible for the privacy practices of such third parties and will not be liable for any use of disclosure, by a third party, of any user’s personal data. This Site may contain links to other World Wide Web sites or advertisements for, or placed by, third parties. SIP is not responsible for the privacy practices of such Web sites, advertisers, or third parties, or for the content of such sites or advertisements. It is possible that these links or advertisements, themselves, may be used by third parties or others to collect personal or other information about Site visitors. It is solely the visitors' obligation to review and understand the privacy practices and policies of these other web sites and of these advertisers and third parties. 4. Security Measures SIP has implemented security features to prevent the unauthorized release of or access to users’ personal information. Please be advised, however, that the confidentiality of any communication or material transmitted to or from SIP via this Site or e-mail cannot be guaranteed. Accordingly, SIP is not responsible for the security of information transmitted via the internet. As an alternative to communicating with SIP via e-mail or the internet, visitors can contact SIP by mail at PO Box 2283, Kirkland WA 98033, by phone at (727) 501-4217, or by e-mail at office@oursignin.sprucecare.com . SIP will keep your personal information until it is no longer needed or until you request that we delete it. 5. Your Opt-Out Right You can always choose to withhold any information you do not want to provide, even though the information may be necessary in order for SIP provide you with services through the Site. In addition, except as necessary for SIP to provide the services, information, or products requested by you, you may opt out of having your personally identifiable information used by SIP for secondary purposes, or disclosed by SIP to third parties by contacting SIP in writing via postal mail, at the address set out above. (This does not apply to collection of the type of web browser of the visitor to the Site or to information provided or collected that does not meet the above description.) Such a request may result in SIP declining to provide services to you through the Site or denying you access to the Site. If you have agreed to receive marketing communications from SIP, you may always opt out at a later date. You have the right at any time to stop SIP from contacting you for marketing purposes or giving your data to other third parties. 6. Your Access to and Ability to Correct Personal Data The right to access - You have the right to request copies of your personal data. We may charge you a small fee for this service. The right to rectification - You have the right to request that SIP correct any information you believe is inaccurate. You also have the right to request SIP to complete information you believe is incomplete. The right to erasure - You have the right to request that SIP erase your personal data, under certain conditions. The right to restrict processing - You have the right to request that SIP restrict the processing of your personal data, under certain conditions. The right to object to processing - You have the right to object to SIP’s processing of your personal data, under certain conditions. The right to data portability - You have the right to request that SIP transfer the data that we have collected to another organization, or directly to you, under certain conditions. You may modify, correct, change or update your data by contacting SIP in writing via postal mail, at the address above. 7. Compliance with the Children's Online Privacy Protection Act (COPPA). The Site is not directed at children under the age of 13. SIP complies with the Children’s Online Privacy Protection Act (COPPA) and to the extent that SIP is able to determine the age of users by their submissions to or communications with the Site, SIP will not knowingly collect, use, or disclose personally identifiable information from individuals under the age of thirteen (hereinafter referred to as “Child” or "Children") without their parent's or guardian's consent. SIP does not provide products or services to Children without parental consent. If you are under 13, you may use the Site only with the involvement of a parent or guardian. Upon request from a parent or guardian of a Child who has provided such personally identifiable information to the Site, SIP will: provide to the parent or guardian a description of the specific types of information collected from the Child; provide to the parent or guardian a means and stated procedures to review such information and to halt future disclosure, use, and maintenance of such information (e.g., the parent or guardian has the option to consent to the collection and use of their Child's personally identifiable information without consenting to the disclosure of that information to third parties), as applicable; cease collection in the future of such information from the Child; or provide any combination of the foregoing. SIP is prohibited by law from conditioning a Child's participation in an activity on the Child's disclosure of more personally identifiable information than is reasonably necessary to participate in such activity. 8. SIP's Right to Contact Users SIP reserves the right to contact Site visitors regarding account status and changes to the subscriber agreement, privacy statement, and any other policies or agreements relevant to Site visitors. 9. SIP’s Right to Change Privacy Statement Terms SIP may change this Privacy Statement at any time. It is the obligation of users visiting the Site to familiarize themselves with this Privacy Statement, and any change to this Privacy Statement. 10. Procedure for Correcting or Updating your Information If you would like to update or modify the personal information obtained by SIP through this Site, you may do so by: Sending an email to: office@oursignin.sprucecare.com By mail to the following address: PO Box 2283, Kirkland WA 98033

Healing with Tricia provides secure virtual psychiatric appointments for residents of Washington State specializing in perinatal mental health, ADHD, and medication management. ADHD, Mental Health, and Medication Management Secure virtual appointments for adult residents of Washington State Choose to meet online or at the office in Kirkland, WA Book Free Intro Current Clients A Healing Partnership Hello, I am Tricia. At the heart of my practice is a commitment to truly seeing and hearing you. Your goals are my focus, and together, we build a healing partnership centered on your well-being. I offer convenient, evidence-based psychiatric care through telehealth, allowing you to access quality treatment no matter where you are in Washington State. In working together, you can expect the following: care tailored to you, with a focus on your unique needs and goals. secure communication on a HIPAA-compliant portal, ensuring your privacy is protected. I trained as a Psychiatric Mental Health Nurse Practitioner at Purdue University. If you are in crisis, call 911 or proceed to the Emergency Department at your local hospital. Suicide Prevention Lifeline call or text 988. Mental Health Areas of Focus Psychiatric Evaluation Discussions to understand your mental health needs. Medication Management Safe and effective treatment plans tailored to you. Individual Therapy One-on-one therapy sessions focused on your personal growth. Perinatal Mental Health Specialized care during pregnancy and postpartum. ADHD I am able to diagnose and treat Attention Deficit Hyperactivity Disorder. Accepted Insurance What does my process look like? 1. Start by requesting a free 15-minute discovery phone call. You can do this by calling (425) 246-3740, or clicking the button below. 2. I'll reach out to schedule a convenient time for us to discuss your needs, and we’ll see if my services align with your needs and goals. 3. After the call, if we’re a good match, I'll invite you to our secure portal. You'll create a login, and complete and sign the necessary intake paperwork. 4. Once your paperwork is reviewed, we can schedule your initial appointment. Evening and weekend times are available. Book Your Free Intro (15-Minute Discovery Call) FAQs Do you take in person appointments or only virtual? I do have an office in Kirkland and can take in person appointments. The address can be found in the footer of this website. However, my goal is to provide telehealth, virtual appointments, to make it convenient for people to get care on their terms, in their home or preferred location, wherever they are located in Washington. What insurance do you take? As of now I take: Aetna Regence First Choice Health Premera Cigna United Healthcare Other insurance carriers consider us out-of-network. If we do not yet take your insurance, you may pay for services and seek reimbursement from your carrier. We can provide an invoice, also called a superbill, for this purpose. At this time, I do not accept Medicaid and Medicare. To verify your coverage, please give your insurance the legal name of our office, our NPI, and our EIN: Sign In Psychiatric, PLLC NPI: 1295583862 EIN: 992173523 How does payment work? Our practice does ask that you provide a credit card for us to hold on file for payments. You can pay by American Express, Discover, Mastercard, Visa, Health Savings Account, Health Reimbursement Account, or debit card. A current good faith estimate of client costs is available before scheduling and anytime upon request. Is my information confidential? Yes, all your information is protected by the privacy and confidentiality standards set by Washington State Law and federal HIPAA regulations. What should I do if I have an emergency? If you are experiencing a crisis, please call 911 or go to your nearest emergency room. For non-emergency concerns, you can reach out through the portal. For the Suicide Prevention Lifeline call or text 988 Will I need to take medication? Medication is just one of many treatment options. We’ll discuss the best approach for your specific needs during your consultation. How often will I need to attend sessions? The frequency of sessions depends on your individual treatment plan, which we will develop together based on your goals and needs. Psychiatric Care I provide compassionate care tailored to each individual's unique needs, focusing on effective treatment and support. My approach is designed to help clients navigate their mental health challenges with personalized strategies and medication management. Anxiety Depression ADHD Pregnancy, Prenatal, Postpartum Life Transitions Sleep Disorders Autism Bipolar PTSD