NOTICE OF PRIVACY PRACTICES
Mindful Sasquatch PLLC
Rendering Provider: Ryan Q Patterson, MA, LMHC
Service Address:
14090 Fryelands Blvd, Suite 316
Monroe, WA 98272
Mailing Address:
PO Box 2354
Snohomish, WA 98291-2354
Phone: 425-205-9332
Last Updated: July 16, 2026
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
Under federal law (HIPAA) and Washington State law, you have the following rights with respect to your protected health information (PHI):
Right to Inspect and Obtain Copies
You may request to inspect or receive an electronic or paper copy of your medical record and other health information maintained by this practice.
Copies will generally be provided within 30 days. A reasonable, cost-based fee may apply as permitted by law.
Right to Request Amendment
You may request an amendment to health information you believe is inaccurate or incomplete.
Requests may be denied if the information is accurate, complete, or otherwise exempt under law. Written notice of denial will be provided within 60 days.
Right to Request Confidential Communications
You may request that communications be made in a specific manner or sent to an alternative location.
Reasonable requests will be accommodated.
Right to Request Restrictions
You may request restrictions on certain uses or disclosures of your PHI for treatment, payment, or health care operations.
This practice is not required to agree to all requested restrictions. However, if you pay for a service in full out-of-pocket, you may request that information related to that service not be disclosed to your health insurer, and such request will be honored unless disclosure is otherwise required by law.
Right to an Accounting of Disclosures
You may request an accounting of certain disclosures made within the previous six (6) years, excluding disclosures related to treatment, payment, and health care operations.
One accounting per year is provided at no cost; additional requests may incur a reasonable fee.
Right to a Paper Copy
You may request a paper copy of this Notice at any time, even if you have agreed to receive it electronically.
Right to Designate a Personal Representative
If you have granted medical power of attorney or are under guardianship, your authorized representative may exercise your rights after verification of authority.
Right to File a Complaint
You may file a complaint if you believe your privacy rights have been violated.
Privacy Contact:
Ryan Q Patterson, MA, LMHC
Mindful Sasquatch PLLC
Service Address: 14090 Fryelands Blvd, Suite 316, Monroe, WA 98272
Mailing Address: PO Box 2354, Snohomish, WA 98291-2354
Phone: 425-205-9332
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights: 200 Independence Avenue SW, Washington, DC 20201; telephone 1-800-368-1019 (TDD: 1-800-537-7697); or online at www.hhs.gov/ocr/privacy/hipaa/complaints. Retaliation for filing a complaint is prohibited.
YOUR CHOICES
You may direct how certain information is shared, including disclosures to family members or others involved in your care, or in disaster relief situations.
If you are unable to express a preference, disclosures may be made if determined to be in your best interest or necessary to reduce a serious and imminent threat.
Uses and Disclosures Requiring Written Authorization
This practice will not use or disclose your PHI for the following without your written authorization:
• Marketing purposes
• Sale of PHI
• Most uses or disclosures of psychotherapy notes
Psychotherapy notes receive special protection under HIPAA and are maintained separately from the medical record.
HOW YOUR INFORMATION MAY BE USED AND DISCLOSED
Treatment
Information may be shared with other healthcare professionals involved in your care. For example, with your authorization or as permitted by law, I may coordinate care with your primary care provider, prescriber, or another treating clinician.
Health Care Operations
Information may be used to operate the practice, improve services, and ensure quality of care. Examples include quality review, professional consultation and training, auditing, and business planning and management.
Payment
Information may be disclosed for billing and payment purposes. Examples include submitting claims to your health plan or EAP, verifying insurance coverage and benefits, and billing you or a responsible party for services.
WASHINGTON STATE MANDATORY DISCLOSURES
Washington law permits or requires disclosure of information in circumstances including, but not limited to:
• Suspected abuse, neglect, or abandonment of a child (chapter 26.44 RCW) or suspected abandonment, abuse, neglect, or financial exploitation of a vulnerable adult (chapter 74.34 RCW), which I am required by law to report
• A reasonable belief that disclosure will avoid or minimize an imminent danger to your health or safety or the health or safety of another person (RCW 18.225.105)
• Other circumstances enumerated in RCW 18.225.105 and chapter 70.02 RCW, including disclosures made with your written authorization, in legal proceedings you initiate against this practice, or in response to a subpoena from the Secretary of the Department of Health
When feasible and clinically appropriate, disclosures will be discussed with you in advance.
OTHER PERMITTED OR REQUIRED DISCLOSURES
Disclosures may also occur as required or permitted by law for the following purposes:
• Public health activities, such as reporting communicable disease or adverse events as required by public health authorities
• Health oversight activities, such as audits, investigations, and licensure actions by agencies including the Washington State Department of Health
• Judicial and administrative proceedings, in response to a valid court order, or a subpoena or discovery request accompanied by the protections required by law
• Law enforcement purposes, within the limits established by HIPAA and Washington law
• Workers’ compensation programs, as authorized by law
• Research, in limited circumstances and subject to legally required privacy protections
PRACTICE RESPONSIBILITIES
This practice is required by law to:
• Maintain the privacy and security of your PHI
• Provide notice of a breach without unreasonable delay and no later than sixty (60) days following discovery
• Follow the privacy practices described in this Notice
This Notice may be revised at any time. Revisions apply to all PHI maintained by this practice. If a material revision is made, the updated Notice will be posted in the office and made available through the client portal, and a copy of the current Notice is available upon request at any time.
ACKNOWLEDGEMENT OF RECEIPT
By electronically acknowledging this document, you confirm receipt of the Notice of Privacy Practices.
Version date 7/16/2026