Pronoia Performance, LLC – HIPAA Notice of Privacy Practices
Effective Date: June 1, 2025
Applies To: Pronoia Performance, LLC (“PP,” “we,” “our,” “us”) in its role as a Management Services Organization (Business Associate) providing administrative services to Mindful Medicine, PC (“MM”), the licensed medical practice and covered entity responsible for your clinical care.
Your rights
You have the right to
Right
How to Exercise
Get a copy of your medical record
Submit a written request (mail or email) to PP’s Privacy Officer. We will provide a paper or electronic copy within 30 days
Ask us to correct your record
Same method. We may deny if inaccurate or incomplete information was not created by us; you may add a statement of disagreement.
Request confidential communications
You may ask that we contact you at a different mailing address, phone number, or via secure portal only.
Request a restriction on uses of discolosures
We will honor reasonable requests; we are not required to agree to all restrictions (except for self-paid services under 45 CFR §164.522(a)(1)(vi)).
Get a list of disclosures
Receive an “accounting of disclosures” for the prior 6 years, excluding routine treatment, payment, and health-care-operations uses.
Choose someone to act for you
If you have given someone medical power of attorney or they are your legal guardian, that person can exercise your rights.
File a complaint
See “Complaints” section below; you will not be retaliated against.
Our Uses and Disclosures
We typically use or share your Protected Health Information (“PHI”):
Purpose
Example
Treatment (on MM’s behalf)
Scheduling visits, coordinating with MM’s clinicians, or reminding you of lab appointments.
Payment
Managing subscription invoices, collecting card payments, and transmitting payment data to MM.
Health-Care Operations
Quality assessment, customer-service training, legal/compliance audits, and IT security.
Text Messages & Unsecured Email
We may send appointment reminders or administrative messages by SMS or unencrypted email without PHI. You may opt out or request alternative methods at any time.
We may also share your information for:
Category
Conditions
Business Associates
Vendors performing services for us under a HIPAA-compliant agreement (e.g., U.S.-based cloud hosting).
Public Health & Safety
Reporting adverse events if required by law, preventing serious threats to health or safety.
Legal / Law Enforcement
Court orders, subpoenas, or as otherwise required by federal or Colorado law.
We never sell your PHI or use it for marketing without your written authorization.
Uses and disclosures not listed here will be made only with your written permission, and you may revoke that permission at any time.
Our Responsibilities
Maintain the privacy and security of your PHI in accordance with HIPAA and Colorado law.
Provide you with this notice and abide by its terms.
Notify you without unreasonable delay if a breach compromises the security or privacy of your PHI.
Not use or disclose genetic, psychotherapy, or substance-use treatment notes except as permitted by 45 CFR §164.508.
We reserve the right to change this notice and the revised version will apply to all PHI we maintain. A current copy will always be available on https://pronoiaperformance.com/privacy and by request.
Contact Information
Privacy Officer: Devlon Haase
Mailing Address: 1942 Broadway St, Suite 314C, Boulder, CO 80302
Telephone: (720) 414-3515
Email: [Privacy-Officer-Email]
Complaints
If you believe your privacy rights have been violated, you may file a complaint with:
Pronoia Performance Privacy Officer (contact above), or
U.S. Department of Health & Human Services, Office for Civil Rights
200 Independence Avenue SW, Washington, DC 20201
Phone: (800) 537-7697 | Online: https://ocrportal.hhs.gov
You will not be penalized or retaliated against for filing a complaint.
Acknowledgment
We will ask you to sign a separate form acknowledging receipt of this Notice.
If you decline, we will document our good-faith effort to provide it.
For Colorado Residents
Pronoia Performance currently provides management services solely for patients located in Colorado. Colorado law affords you the same or greater privacy protections as federal law; where state law is more stringent, we follow state requirements.
This Notice is issued jointly by Pronoia Performance, LLC (Business Associate) and Mindful Medicine, PC (Covered Entity). For clinical questions, please contact Mindful Medicine directly.
