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Practice Policies

 

Latched-N-Love, LLC

Client Rights, Privacy Practices, Policies, and Informed Consent
Arlyn Johnson, BS, IBCLC, CBS
Effective Date: 05/2024, Revised 02/2026

1. Acknowledgment of Privacy Practices (HIPAA)

This document describes how your health information may be used and disclosed and how you can access this information. Please review carefully.

I understand that your health information is personal and confidential. I create and maintain records of the services you receive in order to provide quality care and comply with legal requirements. I am required by law to:

  • Maintain the privacy of your Protected Health Information (PHI)

  • Provide you notice of my legal duties and privacy practices

  • Follow the terms of this notice

  • Notify you of any changes to these policies

Updated notices will be available upon request and on my website.

 

2. How Your Health Information May Be Used or Disclosed

Your PHI may be used or disclosed without written authorization for:

Treatment, Payment, and Healthcare Operations

This includes coordination of care, consultation with other providers, referrals, insurance processing, and administrative functions necessary to deliver services.

Legal Requirements

Information may be disclosed when required by law, subpoena, court order, or administrative process.

Public Health and Safety

Disclosures may occur to report abuse, prevent serious threats to safety, or comply with oversight or regulatory agencies.

Other Permitted Disclosures

  • Law enforcement purposes

  • Workers’ compensation claims

  • Medical examiners or coroners

  • Research (without identifying information)

  • Government functions required by law

I may contact you regarding appointment reminders, treatment options, or services offered by this practice.

 

3. Uses Requiring Your Authorization

Your written permission is required for:

  • Release of session notes except for treatment, training, legal defense, oversight investigations, or legal requirements

  • Any marketing use of your PHI

  • Sale of PHI (which will not occur in this practice)

 

4. Disclosures Where You May Object

With your consent, PHI may be shared with individuals involved in your care or payment, unless you object. In emergencies, consent may be obtained retroactively.

 

5. Your Rights Regarding Your Health Information

You have the right to:

  • Request limits on how PHI is used or disclosed

  • Restrict disclosure to insurance if services are paid in full out-of-pocket

  • Request confidential communication methods

  • Receive copies of your records (fees may apply)

  • Request an accounting of disclosures

  • Request corrections to your record

  • Receive this notice in paper or electronic format

 

6. Practice Policies

Appointments & Cancellations

  • Standard consultation time: 60 minutes

  • 24-hour notice required for cancellation or rescheduling

  • Late cancellations or missed visits incur a $50 fee

  • Late arrival may shorten your session

Communication & Accessibility

Voicemail and email may be used for scheduling matters. I aim to respond within 24–48 hours.

For emergencies, call 911 or go to the nearest emergency room.

Electronic Communication & Telehealth

Electronic communication cannot be guaranteed confidential. Telehealth services may be used when appropriate. By consenting to telehealth you acknowledge:

  • You may withdraw consent at any time

  • Confidentiality protections still apply

  • You may access records of telehealth sessions

  • Images or information will not be shared without consent

  • Telehealth may limit provider observations and therefore clinical accuracy

Social Media Policy

To protect confidentiality and professional boundaries, I do not accept client contact on social media platforms.

Minors

Parents or guardians may have legal access to certain information. Appropriate disclosure will be discussed with the minor and guardian.

Termination of Services

Services may be terminated if treatment is not effective, payment is not made, or appointments are missed for three consecutive weeks without prior arrangement. Referrals will be provided upon termination.

 

7. Informed Consent for Lactation Consulting

By signing this document, you acknowledge that lactation consulting services may include:

  • Assessment of breasts, nipples, and infant oral anatomy

  • Observation of breastfeeding

  • Use or demonstration of equipment or techniques

  • Development of a care plan and follow-up recommendations

You understand:

  • Only physicians provide medical diagnosis or medical treatment

  • Progress may require adjustments over time

  • You are responsible for communicating concerns and updates

  • Physician recommendations should be discussed with your doctor before changes

  • Payment is due at time of service

  • Information may be shared with your providers or insurer for coordination or payment

  • De-identified information may be used for education or research purposes

You have the right to refuse any recommended intervention or equipment and may request referrals to other qualified consultants.

All services comply with professional standards and privacy protections required by
International Board of Lactation Consultant Examiners,
International Lactation Consultant Association,
and federal privacy laws administered by the U.S. Department of Health and Human Services.

 

8. Acknowledgment and Consent

By signing below, you confirm that:

  • You have received and reviewed this document

  • You understand your privacy rights and practice policies

  • You consent to lactation consulting services

  • You agree to the financial and communication policies

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