AlviPsych LLC – Notice of Privacy Practices

Effective Date: 12/21/2025

This Notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

1. Who We Are

AlviPsych LLC (“AlviPsych”) operates a technology and administrative platform that facilitates access to psychiatric evaluations performed by independent licensed healthcare providers.

AlviPsych does not provide medical or psychiatric treatment and does not control or direct the clinical judgment of any provider. However, AlviPsych may create, receive, maintain, or transmit certain health information on behalf of providers in order to operate the platform.

For purposes of applicable privacy laws, AlviPsych may act as:

  • A Business Associate, and/or
  • A Covered Entity, depending on the specific services provided

2. Information We Collect

We may collect, store, or transmit the following types of information (“Protected Health Information” or PHI):

  • Identifying information (name, date of birth, contact details)
  • Appointment and scheduling information
  • Intake forms and questionnaires
  • Psychiatric evaluation reports
  • Payment and billing information
  • Communications through the platform
  • Technical data related to platform use (IP address, device type)

3. How We May Use and Disclose Your Information

We may use and disclose your PHI for the following purposes, as permitted by law:

A. Treatment

To facilitate psychiatric evaluations performed by independent providers and to transmit evaluation reports to your surgeon and/or surgical facility for surgical planning and clearance determination.

B. Payment

To collect payment for platform services, process transactions, and address billing inquiries.

C. Health Care Operations

To operate, maintain, and improve the AlviPsych platform, including quality assurance, auditing, security, administrative support, and legal compliance.

D. Required by Law

To comply with applicable federal, state, or local laws, court orders, subpoenas, or regulatory requirements.

E. Business Associates

To vendors or contractors who assist AlviPsych with platform operations (e.g., hosting, payment processing, analytics), all of whom are required to maintain appropriate safeguards.

4. Disclosure to Surgeons and Facilities

With your authorization (as provided in your Informed Consent), evaluation reports and relevant psychiatric information may be disclosed to:

  • Your treating surgeon, and
  • The surgical facility involved in your planned procedure

Disclosures may occur via secure electronic transmission, email, fax, or other standard medical communication methods.

5. Your Rights Regarding Your Information

You have the right to:

  • Access your PHI
  • Request corrections to your PHI
  • Request restrictions on certain uses or disclosures
  • Request confidential communications
  • Receive a copy of this Notice
  • File a complaint if you believe your privacy rights have been violated

Requests must be submitted in writing to AlviPsych using the contact information below.

6. Limitations on Your Rights

Certain rights may be limited when:

  • Information is part of a designated record set maintained by an independent provider
  • Disclosure is required by law
  • Disclosure is necessary to prevent serious harm

7. Safeguards

AlviPsych uses administrative, technical, and physical safeguards to protect your information, including secure servers, encryption, access controls, and audit logs.

No system is 100% secure, and we cannot guarantee absolute security of information transmitted electronically.

8. Breach Notification

In the event of a breach of unsecured PHI, AlviPsych will notify affected individuals in accordance with applicable law.

9. Changes to This Notice

AlviPsych reserves the right to change this Notice at any time. Updated versions will be posted on the platform and will apply to information we maintain.

10. Contact Information

If you have questions, wish to exercise your rights, or want to file a complaint, contact:

Privacy Officer
AlviPsych LLC
Email: info@alvipsych.com
Phone: __________________________

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

11. Acknowledgment

By using the AlviPsych platform, you acknowledge receipt of this Notice of Privacy Practices.


© AlviPsych LLC, All Rights Reserved