Privacy Policy

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Augustine Recovery – Privacy Policy



The Notice includes individual’s rights (HIPAA regulations 42 U.S.C. 1320d et seq., 45 C.F.R. Parts 160 & 164, and the Confidentiality Law, 42 U.S.C. 290dd-2, 42 C.F.R.Part 2) pertaining to his or her PHI and records, and how such rights may be exercised. It covers Augustine Recovery’s legal duties, describes the types of uses and disclosures that are permitted under this law, and how to file a formal grievance.

Bridge to Shore Recovery dba Augustine Recovery’s Release of Information form complies with state and federal regulations and contains the name of the client, content to be released, purpose of information to be released, party to whom the information will be released, date on which the release if signed, the expiration date of the release, information on how to revoke the release, and signature of the client or guardian. Limitations on information desired released may be indicated on the form. Psychotherapy notes are covered under HIPAA, thus are considered Augustine Recovery’s property and are not required to be disclosed to the client. In cases when a client’s information is subpoenaed follow the RESPONDING TO A REQUEST FOR CLIENT RECORDS (INCLUDING SUBPOENAS AND COURT MANDATES). All other PHI in the client’s chart is their property and can be requested by and copied for the client.

HIPAA requires an accounting of disclosures, which is a list of disclosures made without consent or authorization (in order for treatment, payment, or health care operations). All Qualified Service Organization / Business Associate Agreements state that all inadvertent re-disclosures need to be reported to {your facility name” within 24 hours of the incident. If there are cases where information is disclosed without an authorization a disclosure log needs to be implemented in the client’s chart.

HIPAA allows for unintended or incidental disclosure of PHI; however, it is absolutely imperative that any use, submission, or disclosure be documented on an Accounting of Disclosure form and remain in the person’s chart. Documentation should be specific as to what PHI was released, to whom it was released, reason for release, and why a consent for release of information was not obtained. The client and all appropriate parties involved should be notified of the accidental disclosure. An incident report should be completed and submitted to management.

Clients may update their records by completing the Request for Amending Personal Health information form. Amendments of PHI may only be completed if 1) a request has been made by the client and 2) the PHI originated in {your facility name”‘s office.

New employees are trained in HIPAA within the first week of employment. Each staff member signs an agreement acknowledging the HIPAA regulations and penalties for violations of these regulations. The penalties are:

1. $100 per person per violation up to $25,000

2. Criminal – $50,000 fine and up to 1-year imprisonment for wrongful disclosure 

3. Intent to sell, transfer or use PHI for gain is a $25,000 fine and up to 10 years imprisonment


This notice describes how your medical information may be used and disclosed, and how you can access this information. Please review it carefully.
You have rights regarding your personal information. These rights include:

● To obtain an electronic or paper copy of your personal records. Requests for records will be honored within thirty days. A reasonable fee may be charged for printing where applicable.
● To request amendments be made to your records if you feel anything was included or omitted in error. If your request is denied, you will receive a written explanation within sixty days of submission.
● To request a list of persons and entities with whom your information was shared. This accounting of disclosures can include the times we have shared your information and purpose of disclosure for up to six years prior to the request. Please note that Augustine Recovery is compliant with state and federal guidelines.
● To select individuals with whom your information is shared and to specify/limit the nature of disclosures. Such individuals may be professional, familial, or otherwise, and are documented in an electronic ROI (Release of Information). No disclosures will be made without your signed and explicit consent. You may revoke or modify such consent at any time with staff.


Augustine Recovery is committed to protecting the privacy of the personal and health information we collect or create as part of providing health care services to our clients, known as “Protected Health Information” or “PHI”. PHI typically includes your name, address, date of birth, billing arrangements, care, and other information that relates to your health, health care provided to you, or payment for health care provided to you. PHI DOES NOT include information that is de-identified or cannot be linked to you.

This notice of Health Information Privacy Practices (the “Notice”) describes Augustine Recovery’s duties with respect to the privacy of PHI, Augustine Recovery’s use of and disclosure of PHI, client rights and contact information for comments, questions, and complaints.


Augustine Recovery obtains most of its PHI directly from you, through care applications, assessments and direct questions. We may collect additional personal information depending upon the nature of your needs and consent to make additional referrals and inquiries. We may also obtain PHI from community health care agencies, other governmental agencies or health care providers as we set up your service arrangements.

Augustine Recovery is required by law to provide you with this notice and to abide by the terms of the Notice currently in effect. Augustine Recovery reserves the right to amend this Notice at any time to reflect changes in our privacy practices. Any such changes will be applicable to and effective for all PHI that we maintain including PHI we created or received prior to the effective date of the revised notice. Any revised notice will be mailed to you or provided upon request.

Augustine Recovery is required by law to maintain the privacy of PHI. Augustine Recovery will comply with federal law and will comply with any state law that further limits or restricts the uses and disclosures discussed below. In order to comply with these state and federal law. Augustine Recovery has adopted policies and procedures that require its employees to obtain, maintain, use and disclose PHI in a manner that protects client privacy.


Except as outlined below, Augustine Recovery will not use or disclose your PHI without your written authorization. The authorization form is available from Augustine Recovery (at the address and phone number below). You have the right to revoke your authorization at any time, except to the extent that Augustine Recovery has taken action in reliance on the authorization.The law permits Augustine Recovery to use and disclose your PHI for the following reasons without your authorization:

For Your Treatment: We may use or disclose your PHI to physicians, psychologists, nurses and other authorized healthcare professionals who need your PHI in order to conduct an examination, prescribe medication or otherwise provide health care services to you.

To Obtain Payment: We may use or disclose your PHI to insurance companies , government agencies or health plans to assist us in getting paid for our services . For example, we may release information such as dates of treatment to an insurance company in order to obtain payment.
For Our Health Care Operations: We may use or disclose your PHI in the course of activities necessary to support our health care operations such as performing quality checks on your employee services. We may also disclose PHI to other persons not in Augustine Recovery Center’s workforce or to companies who help us perform our health services (referred to as “Business Associates”) . We require these business associates to appropriately protect the privacy of your information .

As Permitted or Required By The Law: In some cases we are required by law to disclose PHI. Such disclosure may be required by statute, regulation, court order, government agency, we reasonably believe an individual to be a victim of abuse, neglect or domestic violence: for judicial and administrative proceedings and enforcement purposes.
For Public Health Activities: We may disclose your PHI for public health purposes such as reporting communicable disease results to public health departments as required by law or when required for law enforcement purposes.

For Health Oversight Activities: We may disclose your PHI in connection with governmental oversight, such as for licensure, auditing and for administration of government benefits. The Florida Department of Children and Families is an example of an agency that oversees The Augustine Recovery’s operations.

To Avert Serious Threat to Health and Safety: We may disclose PHI if we believe in good faith that doing so will prevent or lessen a serious or imminent threat to the health and safety of a person or the public.

Disclosures of Health Related Benefits or Services: Sometimes we may want to contact you regarding service reminders, health related products or services that may be of interest to you, such as health care providers or settings of care or to tell you about other health related products or services offered at Augustine Recovery. You have the right not to accept such information.

Incidental Uses and Disclosures: Incidental uses and disclosures of PHI are those that cannot be reasonably prevented, are limited in nature and that occur as a by-product of a permitted use or disclosure. Such incidental use and disclosures are permitted as long as Augustine Recovery uses reasonable safeguards and uses or disclose only the minimum amount of PHI necessary.

To Personal Representatives: We may disclose PHI to a person designated by you to act on your behalf and make decisions about your care in accordance with state law. We will act according to your written instructions in your chart and our ability to verify the identity of anyone claiming to be your personal representative.

To Family and Friends: We may disclose PHI to persons that you indicate are involved in your care or the payment of care. These disclosures may occur when you are not present, as long as you agree and do not express an objection. These disclosures may also occur if you are unavailable, incapacitated, or facing an emergency medical situation and we determine that a limited disclosure may be in your best interest. We may also disclose limited PHI to public or private entity that is authorized to assist in disaster relief efforts in order for that entity to locate a family member or other person that may be involved in caring for you. You have the right to limit or stop these disclosures.


Access to Certain Records: You have the right to inspect and copy your PHI in a designated record set except where State law may prohibit client access. A designated record set contains medical and billing and case management information. If we do not have your PHI record set but know who does, we will inform you how to get it. If our PHI is a copy of information maintained by another health care provider, we may direct you to request the PHI from them. If Augustine Recovery produces copies for you, we may charge you up to $1.00 per page up to a maximum fee of $50.00. Should we deny your request for access to information contained in your designated record set, you have the right to ask for the denial to be reviewed by another healthcare professional designated by Augustine Recovery . Amendments to Certain Records: You have the right to request certain amendments to your PHI if, for example, you believe a mistake has been made or a vital piece of information is missing. Augustine Recovery is not required to make the requested amendments and will inform you in writing of our response to your request.

Accounting of Disclosures: You have the right to receive an accounting of disclosures of your PHI that were made by Augustine Recovery for a period of six (6) years prior to the date of your written request. This accounting does not include for purposes of treatment, payment, health care operations or certain other excluded purposes, but includes other types of disclosures, including disclosures for public health purposes or in response to a subpoena or court order.

Restrictions: You have the right to request that we agree to restrictions on certain uses and disclosures of your PHI, but we are not required to agree to your request. You cannot place limits on uses and disclosures that we are legally required or allowed to make. Revoke Authorizations: You have the right to revoke any authorizations you have provided, except to the extent that Augustine Recovery has already relied upon the prior authorization. Delivery by Alternate Means or Alternate Address: You have the right to request that we send your PHI by alternate means or to an alternate address. Complaints & How to contact us: If you believe your privacy rights have been violated, you have the right to file a complaint by contacting The Augustine Recovery at the address and/or phone number indicated below

3930 US 1 South
St. Augustine, FL 32086

You also have the right to file a complaint with the Secretary of the United States Department of Health and Human services in Washington, D.C. Augustine Recovery will not retaliate against you for filing a complaint. If you believe your privacy rights have been violated, you may make a complaint by contacting Linda Potere, HIPAA Privacy Officer at (561) 738-1369 or the Secretary for the Department of Health and Human Services. No individual will be retaliated against for filing a complaint.

The U.S.Department of Health and Human Services

200 Independence Avenue, S.W.
Washington, D.C. 20201
Toll Free: 1-877-696-6775


This Privacy Policy governs the manner in which Augustine Recovery collects, uses, maintains and discloses information collected from users (each, a “User”) of the website (“Site”). This privacy policy applies to the Site and all products and services offered by Augustine Recovery

Personal identification information

We may collect personal identification information from Users in a variety of ways, including, but not limited to, when Users visit our site, subscribe to the newsletter, respond to a survey, fill out a form, and in connection with other activities, services, features or resources we make available on our Site. Users may be asked for, as appropriate, name, email address, mailing address, phone number. Users may, however, visit our Site anonymously. We will collect personal identification information from Users only if they voluntarily submit such information to us. Users can always refuse to supply personally identification information, except that it may prevent them from engaging in certain Site related activities.

Non-personal identification information
We may collect non-personal identification information about Users whenever they interact with our Site. Non-personal identification information may include the browser name, the type of computer and technical information about Users means of connection to our Site, such as the operating system and the Internet service providers utilized and other similar information.

Web browser cookies

Our Site may use “cookies” to enhance User experience. User’s web browser places cookies on their hard drive for record-keeping purposes and sometimes to track information about them. User may choose to set their web browser to refuse cookies, or to alert you when cookies are being sent. If they do so, note that some parts of the Site may not function properly.

Advertising through third party vendors

Augustine Recovery uses remarketing or similar audiences to display ads online.• Augustine Recovery uses Adwords and Google, shows advertisements for Augustine Recovery on websites across the Internet. Augustine Recovery uses Adwords and Google, utilizes cookies to serve ads depending on a user’s past visits to Visitors can opt out of the use of cookies by Google by going to their Ads Settings.• You can opt out of a third-party vendor’s use of cookies at Network Advertising Initiative opt-out page.How we use collected informationThe Augustine Recovery may collect and use Users personal information for the following purposes: To improve customer service Information you provide helps us respond to your customer service requests and support needs more efficiently.• To personalize user experience We may use information in the aggregate to understand how our Users as a group use the services and resources provided on our Site.• To improve our Site We may use feedback you provide to improve our products and services.• To process payments We may use the information Users provide about themselves when placing an order only to provide service to that order. We do not share this information with outside parties except to the extent necessary to provide the service.• To send periodic emails We may use the email address to send User information and updates pertaining to their order. It may also be used to respond to their inquiries, questions, and/or other requests. If User decides to opt-in to our mailing list, they will receive emails that may include company news, updates, related product or service information, etc. If at any time the User would like to unsubscribe from receiving future emails, we include detailed unsubscribe instructions at the bottom of each email or User may contact us via our Site.

How we protect your information

We adopt appropriate data collection, storage and processing practices and security measures to protect against unauthorized access, alteration, disclosure or destruction of your personal information, username, password, transaction information and data stored on our Site.

Sharing your personal information

We do not sell, trade, or rent Users personal identification information to others. Changes to this privacy policy Augustine Recovery has the discretion to update this privacy policy at any time. When we do, we will revise the updated date at the bottom of this page. We encourage Users to frequently check this page for any changes to stay informed about how we are helping to protect the personal information we collect. You acknowledge and agree that it is your responsibility to review this privacy policy periodically and become aware of modifications.

Your acceptance of these terms

By using this Site, you signify your acceptance of this policy. If you do not agree to this policy, please do not use our Site. Your continued use of the Site following the posting of changes to this policy will be deemed your acceptance of those changes.

Opt Out of Further Communications

If you would like to opt out of further communications from Augustine Recovery, please let us know by sending an email using the form on our Contact Page.


Contacting us

If you have any questions about this Privacy Policy, the practices of this site, or your dealings with this site, please contact us at: Augustine Recovery, 3930 U.S. 1 South, Saint Augustine, FL 32086.


Augustine Recovery has always been committed to maintaining the accuracy, confidentiality, and security of your personal and corporate information. We have established Privacy Principles to govern our use of customer information.


Augustine Recovery is responsible for maintaining and protecting customer information under its control.

Identifying Purposes

The purposes for which customer information is collected shall be identified before or at the time the information is collected.


The knowledge and consent of the customer are required for the collection, use or disclosure of customer information except where required or permitted by law.

Limiting Collection

The customer information collected must be limited to those details necessary for the purposes identified by Augustine Recovery, Information must be collected by fair and lawful means.

Limiting Use, Disclosure and Retention

Customer information may only be used or disclosed for the purpose for which it was collected unless the customer has otherwise consented, or when it is required or permitted by law. Customer information may only be retained for the period of time required to fulfill the purpose for which it was collected.


Customer information must be maintained in as accurate, complete and up-to-date form as is necessary to fulfill the purposes for which it is to be used.

Safeguarding Customer Information

Customer information must be protected by security safeguards that are appropriate to the sensitivity level of the information.


Augustine Recovery is required to make information available to customers concerning the policies and practices that apply to the management of their information.

Customer Access

Upon request, a customer shall be informed of the existence, use and disclosure of their information, and shall be given access to it. Customers may verify the accuracy and completeness of their information, and may request that it be amended, if appropriate.

Handling Customer

Complaints and Suggestions
Customers may direct any questions or inquiries with respect to the privacy principles outlined above or about our practices by contacting the designated person(s) accountable for privacy at Augustine Recovery