I do hereby agree and give my consent to Sway Behavioral Healthcare, P.C. (“Sway Health”) to provide health and medical care and treatment considered necessary and proper in diagnosing and/or treating my mental condition.I understand that I have the right to refuse any medical treatment or procedure, and that I may discuss any and all medical treatments or procedures with my healthcare provider.The following documents explain how my care will be delivered, how my personal and health information may be used and protected, the terms under which I may communicate electronically with Sway Health, and the nature, benefits, and risks of receiving psychiatric treatment via telehealth.
I confirm that I have carefully read and understand the following document from Sway Health:
This document outlines the terms and conditions for receiving psychiatric treatment. The services provided include psychiatric evaluations, medication management, and psychoeducation services. By signing this document, you acknowledge your understanding and agreement to these terms.
Your treatment may include a comprehensive psychiatric evaluation leading to diagnosis, medication prescriptions when clinically indicated, and regular follow-up appointments to monitor your progress. Throughout your treatment, you will receive psychoeducation and specific treatment recommendations tailored to your needs. When beneficial for your care, we may coordinate with other healthcare providers to ensure comprehensive treatment.
Psychiatric treatment may include medication management, psychoeducation, and therapeutic interventions. Potential benefits include reduction of symptoms, improved functioning, and improved quality of life. Potential risks may include medication side effects, temporary worsening of symptoms, and the possibility that treatment may not achieve the desired outcome. Your clinician will discuss specific risks and benefits relevant to your individual treatment plan.
Our medication management approach is based on careful clinical assessment and medical necessity. To ensure safe and effective treatment, regular follow-up appointments are required to continue medication treatment. All prescriptions, including controlled substances, are managed in compliance with federal and state regulations. Please note that early medication refills are generally not provided, and in cases of lost or stolen prescriptions for controlled substances, replacement prescriptions may not be issued.
To ensure continuity of care and medication safety, prescription refills will only be provided to patients who maintain regular appointments at least every 30 days. You must have a follow-up appointment scheduled within this timeframe to be eligible for medication refills. This policy ensures that your treatment remains clinically appropriate and allows for proper monitoring of your medication’s effectiveness and any potential side effects. Patients without scheduled follow-up appointments will need to book an appointment before any refills can be processed.
By providing your card information, you allow Sway Health to charge your card for future payments in accordance with their terms. Payment is due after each appointment, and Sway Health will charge your card or bank account for the patient responsibility. Receipts will be provided after each charge, and a single charge may include fees for multiple appointments (due to Sway Health’s billing to health plans).
Your insurance may cover some or all of our services.If you have to pay a deductible, copayment or coinsurance for your health care, the usual cost-sharing rules will apply. While we file insurance claims as a courtesy to our patients, please understand that you are ultimately responsible for payment.Patients who are not using insurance to pay for their appointments will be charged according to the following fee schedule:
We will only charge your card on file under the following circumstances:
Disputes may be submitted in writing to support@swayhealth.co within 30 days of the charge.
Patients may cancel or reschedule an appointment up to 24 hours before the scheduled time without any fees.You may modify your appointment by:
All appointments cancelled or rescheduled with less than 24 hours notice will be charged a $100 cancellation fee. This allows us to offer your appointment slot to other patients who may be waiting. Patients who fail to attend their scheduled appointment without prior notice will also be subject to the cancellation fee.
Patients with Medicaid: Patients covered by Medicaid plans will not be charged cancellation fees for missed appointments. However, patients on Medicaid who miss more than 3 appointments within a 60-day period will not be permitted to continue receiving care from Sway Health.
For your convenience and privacy, all non-urgent communication should be conducted through our secure patient portal. While you may send messages through the portal at any time, please understand that responses may not be provided until your next scheduled appointment. For emergency situations, you should call 911 or proceed to the nearest emergency room. After-hours contact should be reserved for urgent matters only, and email should not be used for clinical communication.
Sway Behavioral Healthcare does not provide emergency or crisis services. If you are experiencing a medical or psychiatric emergency, call 911 or go to the nearest emergency room. You may also contact the 988 Suicide & Crisis Lifeline by calling or texting 988.
To provide you with the most comprehensive care possible, we may share your treatment information with other healthcare providers involved in your care, such as therapists and primary care physicians. This coordination requires your consent, which you can revoke at any time. We believe that open communication between your healthcare providers helps ensure the best possible outcomes for your treatment.
Your healthcare information is protected under HIPAA regulations, and we take this privacy seriously. Information about your treatment will only be released with your written consent, except in specific circumstances required by law. These exceptions include cases of suspected abuse of a child, elderly, or disabled person; situations where there is an imminent threat to your safety or the safety of others; or when required by law or court order.
As our patient, you have the right to participate actively in your treatment decisions, including the right to refuse treatment or medications. You are entitled to know the risks and benefits of any proposed treatment, request changes in your treatment approach, and terminate treatment at any time. All treatment is provided without discrimination and with respect for your personal dignity.
Your health information will be stored securely and protected according to HIPAA privacy and security rules. You acknowledge receipt of Sway’s Notice of Privacy Practices.
At Sway Health, your privacy is not just a legal requirement—it’s a core part of our commitment to delivering respectful, trustworthy care. This combined policy explains how we collect, use, share, and protect your personal and health information across our digital platforms, waitlist, mobile communications, companion app (Baseline by Sway), and telehealth psychiatric services.
We collect information to deliver our services effectively and securely. This includes:
Email address, when you join our waitlist or communicate with us
Mobile phone number, if you opt in to receive text messages
Any other personal data you voluntarily share
Mood logs and personal notes entered into the Baseline app
Clinical reports, medication dosages, and updates from your provider
Information shared during appointments or stored in your patient record
All clinical data is treated as Protected Health Information (PHI) and handled in accordance with HIPAA and applicable state laws.
We use your contact information to share relevant updates, scheduling reminders, app notifications, and news about our services. We do not send unrelated marketing messages.
If you provide your phone number and opt in:
You may receive messages regarding your care or account.
Message and data rates may apply depending on your carrier.
Message frequency may vary based on service usage or clinical needs.
You may opt out at any time by replying “STOP.” For assistance, reply “HELP.”
You can log moods, track your progress, and share entries with your clinician.
Data stored in the app is encrypted and accessible only to authorized users.
You control whether your entries are shared with your care team.
The app may display clinical information, including medication instructions and notes.
We use your PHI to deliver psychiatric services, including:
Diagnosing and treating your condition
Prescribing and monitoring medications
Coordinating with other providers (e.g., therapists, primary care physicians)
Consulting with pharmacies
We may use and disclose information as needed to:
Verify insurance coverage
Process claims and billing
Conduct necessary payment-related communications
We may use information to:
Assess and improve care quality
Train clinical staff and evaluate team performance
Support administrative and compliance functions
We always limit use to the minimum necessary for each purpose.
We do not sell, trade, or share your personal or health information with third parties, except:
With your explicit consent
When required by law (e.g., subpoenas, court orders)
To prevent a serious threat to health or safety
To comply with public health and oversight activities
In cases of suspected abuse or neglect
In every case, we follow the strictest confidentiality and legal standards.
As a virtual care provider, we apply enhanced security protocols to protect your data:
All video sessions are conducted through HIPAA-compliant platforms
Clinicians conduct sessions in private, secure environments
Session data and communications are encrypted and securely stored
Staff are trained on digital privacy best practices
You have the right to:
Access your medical or personal data
Request corrections to inaccurate or incomplete records
Request confidential communication (e.g., by email only or at a specific address)
Restrict disclosures, though we may not always be able to accommodate
Receive an accounting of certain types of disclosures
Withdraw consent for communications at any time
Obtain a copy of this notice, physically or electronically
To exercise your rights, contact us at support@swayhealth.co.
You’re in control of how we communicate and store your information.
Email Opt-Out: Click “unsubscribe” in any email we send
Text Messages: Reply “STOP” to unsubscribe or “HELP” for support
App Data: Manage, modify, or delete entries through the Baseline app settings or email us
Account or Data Removal Requests: Contact us at support@swayhealth.co
We aim to process all requests promptly.
We retain your personal, clinical, and app-related data only as long as necessary to:
Deliver care and services
Meet legal and regulatory requirements
Support internal operations
Once data is no longer needed, it is securely deleted or anonymized.
We may revise this policy as regulations or services change.
Updated versions will be posted at swayhealth.co/privacy-policy
The revised effective date will appear at the top
Major updates may be communicated directly via email or app notification
Have a concern or feel your rights have been violated?
Contact us at:
support@swayhealth.co
You may also file a complaint with the U.S. Department of Health and Human Services.
We do not retaliate against anyone for exercising their rights or filing a complaint.
By using our services—including our website, app, waitlist, and telehealth platform—you acknowledge that you have received, read, and understood this Privacy Policy and Notice of Privacy Practices.
In the event of a breach of your unsecured protected health information, we will notify you as required by the HIPAA Breach Notification Rule (45 CFR §§ 164.400-414). Notification will be provided without unreasonable delay and no later than 60 days after discovery of the breach. Notification will include a description of the breach, the types of information involved, steps you should take to protect yourself, what we are doing to investigate and mitigate the breach, and contact information for further questions.
If you pay for a service or health care item out-of-pocket in full, you have the right to request that we not disclose information about that service or item to your health plan for purposes of payment or healthcare operations. We will honor such requests unless disclosure is required by law.
Psychotherapy notes, as defined under HIPAA (45 CFR § 164.501), receive special protections. We will not use or disclose psychotherapy notes without your specific written authorization, except in limited circumstances permitted by law (e.g., for the originating provider’s own treatment purposes, for training, to defend ourselves in legal proceedings, for HHS investigations, or to avert a serious threat to health or safety). Authorization for release of psychotherapy notes must be separate from any other authorization.
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Our practice is dedicated to maintaining the privacy of your protected health information (PHI). Federal and state law requires us to maintain the confidentiality of your health information and provide you with this notice of our legal duties and privacy practices. We are committed to protecting your rights to privacy and following all legal obligations in handling your PHI.
Your protected health information will primarily be used to provide you with psychiatric treatment. This includes using your information to prescribe and monitor medications, consult with other healthcare providers about your care, share necessary information with pharmacies, and coordinate your care with therapists or primary care physicians when appropriate. We strive to share only the minimum necessary information required for each specific purpose.
We may also need to use your protected health information for payment purposes, such as verifying insurance coverage, processing claims, and conducting collection activities when necessary. Your information helps us obtain payment for services provided and ensure proper billing procedures.
Additionally, we may use your information for healthcare operations, which are necessary activities that support the quality and effectiveness of care we provide. These activities include quality assessment, employee review, training medical students, and maintaining our licensing and credentialing requirements. These operations help us maintain and improve our standard of care.
In certain special circumstances, we may be required or permitted to disclose your health information without your authorization. These situations include public health activities, health oversight activities, cases where we need to avert a serious threat to health or safety, instances required by law, responses to court orders, and cases of abuse or neglect. We are legally obligated to make these disclosures when required.
As a provider of telehealth services, we implement additional measures to protect your privacy during remote sessions. We exclusively use HIPAA-compliant video platforms for all virtual appointments and require our staff to conduct sessions in private settings. All electronic communications are encrypted, and any session-related data is stored securely in compliance with federal regulations. We continuously evaluate and update our security measures to protect your information in the digital environment.
You maintain significant rights regarding your health information. You may request restrictions on how we use and disclose your information, though we are not always required to agree to these restrictions. You have the right to receive confidential communications from us and to inspect and copy your medical records. If you believe information in your record is incorrect, you may request amendments to your health information. You can also receive an accounting of certain disclosures we have made of your health information, and you always have the right to obtain a paper copy of this notice.
Our practice reserves the right to amend this Notice of Privacy Practices at any time in the future. Until such amendment is made, we are required by law to comply with the terms of this notice. After an amendment is made, the revised Notice will apply to all protected health information that we maintain. We will keep a copy of the current notice posted in our office and on our website.
If you have questions about this notice or would like additional information, please contact us at support@swayhealth.co. If you believe your privacy rights have been violated, you may file a complaint with our office or with the Department of Health and Human Services. We will not retaliate against you for filing a complaint.
You acknowledge that you have received a copy of this Notice of Privacy Practices and have been provided an opportunity to review it.
Sway Behavioral Healthcare (Brand names: “Sway Health” and “Baseline by Sway”) strives to provide convenient ways to communicate with our patients while maintaining appropriate security and confidentiality of your health information. This form outlines the various methods of electronic communication available and their associated risks and limitations.
Our primary and most secure method of electronic communication is through our patient portal. By consenting to portal usage, you understand that:
The patient portal allows you to:
Portal messages will typically be responded to within 2 business days for private pay patients. Your provider may not reply to portal messages until your next scheduled appointment. The portal should never be used for emergencies or urgent issues requiring immediate attention.
While email communication is convenient, it has significant limitations and risks. By consenting to email communication, you acknowledge that:
If you choose to authorize email communications, we will limit email content to:
Text message communication is limited to:
By consenting to text message communication, you understand that:
You can opt out of receiving text messages at any time by replying “STOP” to any message. For help with text message services, reply “HELP” to any message. Message frequency may vary.
None of these electronic communication methods should be used for emergencies or urgent situations. For emergencies, you should:
We protect PHI using encryption, secure servers, and HIPAA‑compliant processes.
Email is NOT a secure or encrypted method of communication. Emails may be inadvertently sent to the wrong address, intercepted, altered, forwarded, or accessed without authorization. Email should never be used for emergencies or time-sensitive clinical matters. Email content will be limited to appointment reminders, general follow-up questions, and non-urgent administrative matters.
Standard text messaging is NOT secure or encrypted. Messages may be seen by others with access to your phone, and cell phone carriers may store messages. Message delivery cannot be guaranteed. Message and data rates may apply. You can opt out at any time by replying STOP. For help, reply HELP. Message frequency may vary.
Voicemail messages may be heard by others. We will limit voicemail content to callback requests and appointment reminders unless otherwise authorized.
This document contains important information about providing psychiatric services using telehealth. Please read this carefully and sign to indicate your informed consent to receive telehealth services.
Telehealth involves the use of electronic communications (video conferencing via Healthie’s platform) to enable healthcare providers to deliver psychiatric services remotely. Services provided include psychiatric evaluations, medication management, and psychoeducation.
You have the right to:
You are responsible for:
In case of an emergency during a telehealth session:
If video connection fails:
By signing, you confirm that:
During your telehealth sessions, your provider may use an Artificial Intelligence (AI) scribe tool to assist in documenting session notes. This tool is designed to improve accuracy, efficiency, and allow your provider to focus more fully on your care.
By agreeing to these terms, you acknowledge that:
If you have questions or need support regarding these Terms and Conditions, please contact:
These documents explain how my care will be delivered, how my personal and health information may be used and protected, the terms under which I may communicate electronically with Sway Health, and the nature, benefits, and risks of receiving psychiatric treatment via telehealth.
