Privacy Policy

ZOE Integrated Wellness, PLLC
Website: www.zoeintegratedwellness.net
Last Updated: 03/24/26

1. Information We Collect

A. Information You Provide Directly

We may collect personal information that you voluntarily provide, including:

Name, email address, phone number, and mailing address
Appointment or intake information
Account or portal login details
Payment or billing information (when applicable)
Messages, forms, or other communications you submit

B. Information Collected Automatically

When you visit our website, we may automatically collect:

IP address, browser type, device information
Pages visited, time spent on the site, and general usage data
Cookies or similar tracking technologies used for functionality and analytics

C. Information from Third Parties

We may receive limited information from:

Service providers assisting with scheduling, billing, analytics, or secure communication
Public sources used for identity verification or fraud prevention

2. How We Use Personal Information

We use your information to support the mission and operations of ZOE Integrated Wellness, PLLC, including:

A. Service Delivery

Scheduling and managing appointments
Providing clinical, wellness, or administrative services
Maintaining secure client records

B. Communication

Responding to inquiries or service requests
Sending appointment reminders or administrative updates
Providing newsletters or promotional content (only if you opt in)

C. Security, Compliance, and Operations

Protecting against fraud, misuse, or unauthorized access
Complying with legal, regulatory, or professional obligations
Improving website performance and user experience

3. How Information Is Shared

ZOE Integrated Wellness, PLLC does not sell your personal information.

We may share information only in the following limited circumstances:

A. Service Providers

We may share information with trusted vendors who assist with:

Scheduling and telehealth platforms
Secure data hosting
Payment processing
Website analytics

These providers are required to protect your information and use it only for the services they provide.

B. Legal or Safety Requirements

Information may be disclosed if necessary to:

Comply with laws, subpoenas, or court orders
Protect the rights, safety, or property of clients, staff, or the public

C. Business or Organizational Changes

If ZOE Integrated Wellness, PLLC undergoes a merger, acquisition, or restructuring, personal information may be transferred under the same privacy protections.

4. Opt-Out Choices and Consumer Controls

We respect your right to control your personal information.

A. Marketing Communications

You may opt out of promotional emails at any time by:

Clicking “unsubscribe” in any email
Contacting us directly with your request

B. Cookies and Tracking

You may adjust your browser settings to limit or block cookies. Some website features may not function fully if cookies are disabled.

C. Data Sharing Preferences

If you opt out of certain types of data sharing (such as analytics or marketing-related sharing), we will honor your request.

Opt-out information is not sold or shared with third parties for their own marketing.
If a service provider must receive limited information to implement your opt-out (e.g., disabling analytics), we share only what is necessary.

D. Mobile/Text Messaging Consent

No mobile opt-in or text message consent will be shared with third parties or affiliates.
This includes phone numbers, consent records, and any related communication preferences.

5. How We Protect Your Information

We use administrative, technical, and physical safeguards designed to protect your personal information from unauthorized access, disclosure, or misuse. While we strive to maintain strong security, no system can guarantee absolute protection.

6. Changes to This Policy

We may update this Privacy Policy periodically. When changes occur, we will revise the “Last Updated” date and provide notice when required.

7. Contact Us

For questions about this Privacy Policy or to exercise your privacy rights, please contact:

Email: zoewellness07@gmail.com
Phone: 928-395-5803
Address: 1748 Leisure World, Mesa, Az. 85206

ZOE Integrated Wellness, PLLC
Website: www.zoeintegratedwellness.net
Last Updated: 03/24/26

1. Acceptance of Terms

By accessing or using the website of ZOE Integrated Wellness, PLLC (“we,” “our,” or “us”), you agree to be bound by these Terms of Service. If you do not agree, please discontinue use of the site and services.

2. Services Provided

ZOE Integrated Wellness, PLLC provides mental health, wellness, and related professional services.
Use of this website does not establish a therapeutic relationship. A therapeutic relationship is established only after completing intake procedures, signing required documents, and meeting with a licensed provider.

3. Eligibility

You must be at least 18 years old to use this website unless a parent or legal guardian provides consent for services.

4. Use of the Website

You agree not to:

Use the website for unlawful or harmful purposes
Attempt to gain unauthorized access to systems or data
Interfere with website functionality or security
Use automated tools to extract or copy website content

We may suspend or terminate access for violations of these terms.

5. No Emergency Services

ZOE Integrated Wellness, PLLC does not provide crisis or emergency services through this website.
If you are experiencing an emergency, call 911 or go to the nearest emergency room.

6. Intellectual Property

All website content—including text, graphics, logos, and materials—is the property of ZOE Integrated Wellness, PLLC and may not be reproduced, distributed, or modified without written permission.

7. Payments and Billing

If services require payment:

Fees will be disclosed prior to service
Payment is due at the time of service unless otherwise agreed
Returned or failed payments may result in additional fees

8. Third-Party Links

Our website may contain links to third-party sites. We are not responsible for the content, privacy practices, or accuracy of those sites.

9. Disclaimer

The website is provided “as is” without warranties of any kind.
We do not guarantee:

Error-free operation
Uninterrupted access
Accuracy of information

Nothing on the website constitutes medical or legal advice.

10. Limitation of Liability

To the fullest extent permitted by law, ZOE Integrated Wellness, PLLC is not liable for:

Damages resulting from website use
Loss of data
Unauthorized access to your information

11. Changes to Terms

We may update these Terms of Service at any time. Continued use of the website constitutes acceptance of updated terms.

12. Contact Information

For questions about these Terms of Service:
ZOE Integrated Wellness, PLLC
Email: zoewellness07@gmail.com
Phone: 928-395-5803
Address: 1748 Leisure World, Mesa, Az. 85206

HIPAA NOTICE OF PRIVACY PRACTICES

ZOE Integrated Wellness, PLLC
Effective Date: 03/24/26

This Notice describes how your protected health information (PHI) may be used and disclosed, and how you can access your information. Please review it carefully.

1. Our Responsibilities

ZOE Integrated Wellness, PLLC is required by law to:

Maintain the privacy of your PHI
Provide you with this Notice of Privacy Practices
Notify you if a breach occurs involving your unsecured PHI
Follow the terms of this Notice

2. How We May Use and Disclose Your PHI

A. For Treatment

We may use and share PHI to provide, coordinate, or manage your care.
Example: Consulting with another healthcare provider involved in your treatment.

B. For Payment

We may use PHI to obtain payment for services.
Example: Submitting information to your insurance company.

C. For Healthcare Operations

We may use PHI for administrative, quality improvement, and practice management purposes.
Example: Reviewing provider performance or evaluating service quality.

3. Other Uses and Disclosures Allowed by Law

We may disclose PHI without your written authorization in situations such as:

Public health reporting
Abuse, neglect, or exploitation reporting
Health oversight activities
Legal proceedings or court orders
Serious threats to health or safety
Workers’ compensation claims
Law enforcement purposes (when required)

4. Uses and Disclosures Requiring Your Written Authorization

We will obtain your written permission before:

Using PHI for marketing
Sharing psychotherapy notes (except in limited legal circumstances)
Selling your PHI
Any use or disclosure not described in this Notice

You may revoke authorization at any time in writing.

5. Your Rights Regarding Your PHI

A. Right to Access

You may request to inspect or obtain a copy of your PHI.

B. Right to Amend

You may request corrections to your PHI if you believe it is inaccurate or incomplete.

C. Right to Request Restrictions

You may request limits on how your PHI is used or disclosed.
We are not required to agree, except for certain disclosures to health plans when you pay out-of-pocket in full.

D. Right to Confidential Communications

You may request that we contact you at a specific phone number, address, or email.

E. Right to an Accounting of Disclosures

You may request a list of certain disclosures made in the past six years.

F. Right to a Paper or Electronic Copy of This Notice

You may request a copy at any time.

6. Mobile/Text Messaging Privacy

ZOE Integrated Wellness, PLLC may send appointment reminders or administrative messages via text message only with your consent.
No mobile opt-in or text message consent will be shared with third parties or affiliates.

7. Changes to This Notice

We may update this Notice at any time. Updated versions will be posted on our website and available upon request.

8. Questions or Complaints

If you believe your privacy rights have been violated, you may file a complaint with:

ZOE Integrated Wellness, PLLC
Email: zoewellness07@gmail.com
Phone: 928-395-5803
Address: 1748 Leisure World, Mesa, Az. 85206

You may also file a complaint with the U.S. Department of Health and Human Services.
We will not retaliate for filing a complaint.

If you’d like, I can also create:

A Client Rights & Responsibilities document
A Telehealth Consent
A Practice Policies & Procedures handout
A Good Faith Estimate (No Surprises Act) form

CLIENT RIGHTS & RESPONSIBILITIES

ZOE Integrated Wellness, PLLC
Last Updated: 03/24/26

At ZOE Integrated Wellness, PLLC, we believe that every client deserves compassionate, respectful, and ethical care. This document outlines your rights as a client, as well as the responsibilities that support a safe and effective therapeutic relationship.

YOUR RIGHTS

1. Right to Respect and Dignity

You have the right to be treated with courtesy, compassion, and without discrimination based on race, ethnicity, gender, sexual orientation, religion, disability, or any other protected characteristic.

2. Right to Confidentiality

You have the right to privacy regarding your personal and health information. Your information will not be shared without your written consent except as required by law (e.g., safety concerns, abuse reporting, court orders).

3. Right to Informed Consent

You have the right to understand:

The nature and purpose of treatment
Risks and benefits
Alternatives to treatment
Your right to withdraw consent at any time

4. Right to Participate in Treatment Decisions

You may collaborate in developing your treatment plan, ask questions, and request changes to your goals or approach.

5. Right to Access Your Records

You may request to review or obtain copies of your clinical records, consistent with state and federal laws.

6. Right to Culturally Sensitive Care

You may request accommodations that support your cultural, linguistic, or accessibility needs.

7. Right to Decline Services

You may refuse any recommended service or request a referral to another provider.

8. Right to File a Complaint

You may express concerns or file a complaint without fear of retaliation. Complaints may be submitted directly to ZOE Integrated Wellness, PLLC or to applicable licensing boards.

YOUR RESPONSIBILITIES

1. Provide Accurate Information

You agree to provide complete and accurate information relevant to your care.

2. Attend Scheduled Appointments

You are responsible for:

Attending appointments on time
Providing adequate notice for cancellations
Understanding that late cancellations or no-shows may result in fees

3. Participate in Treatment

You agree to engage in the therapeutic process, follow agreed-upon treatment plans, and communicate openly with your provider.

4. Respect Boundaries

You agree to maintain appropriate boundaries and behave respectfully toward staff and other clients.

5. Financial Responsibility

You are responsible for:

Paying fees at the time of service
Understanding your insurance benefits (if applicable)
Notifying us of changes to your insurance or payment information

6. Technology Responsibilities (Telehealth)

You agree to:

Use a private, secure location for sessions
Ensure your device and internet connection are functioning
Not record sessions without written consent

If you have questions about your rights or responsibilities, please contact us at:
ZOE Integrated Wellness, PLLC
Email: zoewellness07@gmail.com
Phone: 928-395-5803
Address: 1748 Leisure World, Mesa, Az. 85206

TELEHEALTH CONSENT

ZOE Integrated Wellness, PLLC
Last Updated: 03/24/26

This Telehealth Consent outlines your rights, responsibilities, and the conditions under which telehealth services are provided by ZOE Integrated Wellness, PLLC. Please read carefully before participating in telehealth sessions.

1. What Is Telehealth

Telehealth involves the use of electronic communications (video, phone, or secure messaging) to provide clinical services when you and your provider are not in the same location.

2. Potential Benefits

Increased access to care
Convenience and reduced travel time
Continuity of care when in-person sessions are not possible

3. Potential Risks

While telehealth is generally safe and effective, risks may include:

Technology failures or interruptions
Limited ability to observe nonverbal cues
Security vulnerabilities despite reasonable safeguards

4. Confidentiality and Privacy

Your privacy is protected under HIPAA and state law.
ZOE Integrated Wellness, PLLC uses secure, encrypted platforms for telehealth.

Important:
No mobile opt-in or text message consent will be shared with third parties or affiliates.

Confidentiality may be broken only in legally required situations such as:

Risk of harm to self or others
Suspected abuse or neglect
Court orders

5. Client Responsibilities During Telehealth

You agree to:

Participate from a private, quiet, and safe location
Use a secure internet connection (not public Wi-Fi)
Ensure your device is functioning properly
Not record sessions without written permission
Inform your provider of your physical location at the start of each session (required for emergency purposes)

6. Emergency Procedures

Telehealth is not appropriate for emergencies.
If you are in crisis or immediate danger, call 911 or go to the nearest emergency room.

You must provide:

Your current physical address at each session
An emergency contact who may be reached if safety concerns arise

7. Appropriateness of Telehealth

Your provider may determine that telehealth is not clinically appropriate and may recommend in-person care or referral.

8. Consent to Telehealth By signing this consent (physically or electronically), you acknowledge that:

You understand the risks and benefits of telehealth
You agree to participate voluntarily
You may withdraw consent at any time
You understand that telehealth may not be suitable for all clinical needs

9. Contact Information

For questions about telehealth services, please contact:

ZOE Integrated Wellness, PLLC
Email: zoewellness07@gmail.com
Phone: 928-395-5803

Website: www.zoeintegratedwellness.net

PRACTICE POLICIES & PROCEDURES

ZOE Integrated Wellness, PLLC
Last Updated: 03/24/26

These policies and procedures outline how our practice operates and what clients can expect when receiving services at ZOE Integrated Wellness, PLLC.

1. Appointments & Scheduling

Sessions are typically 45–55 minutes unless otherwise arranged.
Appointments may be scheduled online, by phone, or through our client portal.
Telehealth sessions are available when clinically appropriate.

2. Cancellation & No-Show Policy

Cancellations must be made at least 24 hours in advance.
Late cancellations or missed appointments may result in a fee.
Excessive missed appointments may lead to referral or discontinuation of services.

3. Fees & Payment

Payment is due at the time of service unless otherwise arranged.
Accepted forms of payment include: [Insert accepted payment methods].
Clients are responsible for understanding their insurance benefits (if applicable).
Outstanding balances must be resolved before scheduling additional sessions.

4. Insurance & Reimbursement

If insurance is accepted, claims will be submitted on your behalf.
Clients are responsible for deductibles, co-pays, and non-covered services.
If out-of-network, a superbill may be provided upon request.

5. Communication

Non-urgent communication may occur via phone, email, or secure messaging.
Providers do not offer crisis or emergency services outside scheduled sessions.
Messages will be returned within a reasonable timeframe, typically 1–2 business days.

6. Emergencies

ZOE Integrated Wellness, PLLC does not provide emergency services.
In an emergency, call 911 or go to the nearest emergency room.

7. Confidentiality

Your information is protected under HIPAA and state law.
Confidentiality may be broken only when required by law, including:

Risk of harm to self or others
Suspected abuse or neglect
Court orders

No mobile opt-in or text message consent will be shared with third parties or affiliates.

8. Telehealth

Telehealth services follow the same standards of care as in-person sessions.
Clients must participate from a private, safe location.

9. Termination of Services

Services may be discontinued if:

Treatment goals are met
The client requests termination
The provider determines treatment is no longer appropriate
Policies are repeatedly violated

Referrals will be provided when possible.

10. Client Responsibilities

Clients are expected to:

Participate actively in treatment
Communicate openly with their provider
Attend scheduled sessions
Follow safety recommendations

GOOD FAITH ESTIMATE (NO SURPRISES ACT)

ZOE Integrated Wellness, PLLC
Effective Date: [Insert Date]

Under the No Surprises Act, you have the right to receive a Good Faith Estimate (GFE) explaining the expected cost of your mental health services.

1. Purpose of This Estimate

This GFE outlines the anticipated costs of services you may receive. Actual costs may vary depending on:

Frequency of sessions
Duration of treatment
Changes in your treatment plan

2. Client Information

Client Name: __________________________
Date of Birth: _________________________
Estimate Date: _________________________

3. Provider Information

Provider Name: _________________________
Practice: ZOE Integrated Wellness, PLLC
Email: zoewellness07@gmail.com
Phone: 928-395-5803
Address: 1748 Leisure World, Mesa, Az. 85206

4. Services & Estimated Costs

Service

CPT Code

Fee per Session

Estimated Annual Total*

Initial Intake Evaluation

90791

$________

Individual Therapy (45–55 min)

90837/90834

$________

Telehealth Therapy

Same as above

$________

Other Services (specify)

______

$________

*Annual totals are based on an estimated number of sessions (e.g., weekly, biweekly, monthly).
This is only an estimate, not a contract.

5. Disclaimer

This estimate is not a guarantee of final charges.
Additional services may be recommended as clinically appropriate.
You may request an updated GFE at any time.

6. Acknowledgment

I acknowledge that I received and reviewed this Good Faith Estimate.

Client Signature: ___________________________
Date: ___________________

SOCIAL MEDIA & ELECTRONIC COMMUNICATION POLICY

ZOE Integrated Wellness, PLLC
Last Updated: [Insert Date]

This policy explains how ZOE Integrated Wellness, PLLC manages social media, digital communication, and online interactions to protect your privacy and maintain professional boundaries.

1. Social Media Boundaries

Providers do not accept friend requests or follow clients on personal social media accounts.
Providers will not interact with clients on social media platforms.
Clients are discouraged from posting public comments or reviews that reveal their treatment relationship.

2. Electronic Communication

Email and text messaging may be used for administrative purposes only, such as scheduling.
Clinical discussions should occur during sessions or through secure messaging.
Providers do not offer therapy via social media, direct messaging, or unsecure platforms.

No mobile opt-in or text message consent will be shared with third parties or affiliates.

3. Online Reviews

Clients may leave reviews voluntarily, but providers cannot respond due to confidentiality laws.
A lack of response does not indicate agreement or disagreement.

4. Telehealth Platforms

Telehealth is conducted only through secure, HIPAA-compliant platforms.

5. Emergencies

Electronic communication is not monitored continuously.
For emergencies, call 911 or go to the nearest emergency room.

RELEASE INFORMATION (ROI) FORM

ZOE Integrated Wellness, PLLC

This form authorizes ZOE Integrated Wellness, PLLC to release or obtain protected health information (PHI) as specified below.

1. Client Information

Client Name: __________________________________
Date of Birth: _________________________________
Phone Number: _________________________________

2. Recipient of Information

I authorize ZOE Integrated Wellness, PLLC to:
☐ Release information to
☐ Obtain information from

Name/Organization: _____________________________
Address: _______________________________________
Phone: _________________________________________
Fax: ___________________________________________

3. Information to Be Released

(Check all that apply)

☐ Treatment summary
☐ Diagnosis
☐ Progress notes
☐ Medication information
☐ Attendance verification
☐ Entire record
☐ Other (specify): ________________________________

4. Purpose of Disclosure

☐ Coordination of care
☐ Legal purposes
☐ Insurance
☐ Personal use
☐ Other: _________________________________________

5. Expiration

This authorization expires on:
Date: __________________ OR
☐ At the end of treatment
☐ One year from the date signed

6. Your Rights

You may revoke this authorization at any time in writing.
Revocation does not apply to information already released.
Refusal to sign will not affect your ability to receive services.
Information disclosed may no longer be protected once released to a third party.

7. Signature

Client Signature: _______________________________
Date: ___________________

Parent/Guardian (if applicable): __________________
Relationship: ___________________

Provider Signature: _____________________________
Date: ___________________