Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.

Apricity Mental Health PLLC is committed to protecting the privacy and security of your health information. This notice explains your rights, our responsibilities, and how to contact us with privacy questions or concerns.

Good Faith Estimate

Apricity Mental Health PLLC provides cash-pay services. If you do not have insurance or do not plan to use insurance for your care, you have the right to receive a written Good Faith Estimate explaining the expected cost of your care. You may request an estimate before scheduling, and an estimate will also be provided when services are scheduled within applicable federal timeframes.

If a bill from a listed provider is at least $400 more than that provider’s Good Faith Estimate, you may be eligible for the federal patient-provider dispute-resolution process.

For questions or to request an estimate, contact Apricity at 480-620-7857 or Apricity.mhealth@gmail.com Learn more at CMS.gov/nosurprises

Apricity Mental Health PLLC is an outpatient practice and does not provide emergency services or 24/7 crisis monitoring. The website, portal, email, text, and voicemail are not continuously monitored. If you are experiencing an emergency or may harm yourself or someone else, call 911, call or text 988, or go to the nearest emergency department.

Please do not include sensitive medical information, medication details, or urgent safety concerns in this form. This form is for general inquiries and scheduling only.