Informed Consent and HIPAA Notice of Privacy Practices

(v. 3.7)

LSATaccommodations.com | American Disabilities Testing Association LLC

Last Updated: July 4, 2026

Acceptance of This Notice

By accessing or using LSATaccommodations.com, and by checking the acknowledgment checkbox during checkout or account creation, youacknowledge that you have read, understood, and agree to this Informed Consent and HIPAA Notice of Privacy Practices.

Your continued use of the Website after any updates constitutes your reaffirmation of agreement. This Notice works together with our Terms of Use and Privacy Policy.

If you do not agree to this Notice, you should not use the platform or proceed with services.

PART 1: INFORMED CONSENT FOR LSAT ACCOMMODATION DOCUMENTATION SERVICES

Introduction and Nature of Services

Welcome to LSATaccommodations.com, operated by American Disabilities Testing Association LLC ("Company," "we," "us," or "our"). We operate a secure online platform that connects individuals seeking LSAT accommodations, LSAC accommodations documentation, and other standardized-testing accommodation documentation with independent licensed psychologists for the purpose of clinical evaluation and preparation of documentation packets in support of accommodation requests submitted to testing organizations such as LSAC.

This is a matching and facilitation service only. The Company does not itself provide psychotherapy, counseling, emergency care, medication management, legal advice, or ongoing clinical treatment. The clinical assessment and any resulting LSAT accommodation documentation packet are provided solely by the independent licensed psychologist with whom you are matched.

For LSAT accommodation documentation, we use licensed psychologists only. Associates, interns, assistants, or supervised trainees do not perform LSAT accommodation evaluations, make clinical determinations, or sign LSAC Qualified Professional documentation through this platform.

By using this platform and agreeing to this Notice, you are consenting to:

1. the terms of the platform, and
2. receiving services from the specific licensed psychologist to whom you are matched.

Consent to the Platform — American Disabilities Testing Association LLC

By using this platform and agreeing to this Notice, you consent to the Company:

• Collecting, processing, and storing your personal and health-related information for the purpose of matching you with an appropriate licensed psychologist.
• Facilitating the connection between you and an independent licensed psychologist.
• Processing payments and managing billing.
• Delivering documents and communications electronically.
• Using de-identified data for platform improvement and analytics, where permitted.

You understand that the Company acts as a facilitator and is not responsible for the independent clinical judgment, advice, evaluation, or documentation provided by the licensed psychologist.

Telehealth Services

Services on this platform are delivered primarily through secure telehealth, video, phone, electronic intake, or other approved remote means.

Benefits of Telehealth

Telehealth provides easier and more convenient access to care, allows you to receive services from your home or preferred location, and offers greater scheduling flexibility without the need for in-person appointments.

Risks and Limitations of Telehealth

You understand and accept the following risks and limitations:

• The quality, accuracy, or effectiveness of services may be limited compared to an in-person evaluation.
• Technology issues, such as internet instability, software problems, or device failure, may interrupt or prevent the session.
• The psychologist may have limited ability to observe physical cues or conduct certain assessments that would be possible in person.
• There are potential privacy and security risks with electronic communications, even when using secure platforms.
• Telehealth may not be appropriate for all situations or conditions.

You acknowledge that telehealth technology may contain bugs, errors, or limitations that could affect the quality or availability of the evaluation or related communications.

Technical Requirements

You are responsible for having a stable internet connection, a compatible device with camera and microphone if a video session is required, and a private location for your consultation or evaluation.

Emergencies

This platform is not intended for medical or psychiatric emergencies. If you are experiencing a medical emergency, mental health crisis, or thoughts of harming yourself or others, immediately call 911 or go to the nearest emergency room. You may also call or text 988 to reach the 988 Suicide & Crisis Lifeline.

If a technical failure prevents communication during a scheduled session, please contact us at info@LSATaccommodations.com.

Right to Withdraw from Telehealth

You have the right to withdraw your consent to telehealth at any time without penalty. You may request alternative care arrangements if available or discontinue the process.

Consent to Receive Documentation Electronically

By checking the acknowledgment box or continuing to use the platform, you consent to receive your LSAT accommodation documentation packet and any related communications electronically via email and/or through the secure LSATaccommodations.com portal.

You understand that while the portal uses secure methods, standard email transmission is not 100% secure. You accept this risk and agree to keep your email address and contact information current and accurate.

Consent to the Matched Licensed Psychologist

You further consent to receive clinical assessment services from the specific licensed psychologist to whom you are matched through this platform. This includes the psychologist conducting an evaluation, via telehealth, secure intake review, phone, video, or other approved means, for the purpose of determining whether LSAT accommodation documentation is clinically appropriate.

You acknowledge that the licensed psychologist is an independent provider and not an employee or agent of the Company. The licensed psychologist is solely responsible for the professional services they render, including clinical judgment, evaluation findings, and any documentation they sign.

Nature of the Evaluation and Documentation Process

The evaluation is for the limited purpose of assessing whether documentation in support of LSAT or other testing accommodations is clinically appropriate. It is not psychotherapy, counseling, medication management, emergency care, or ongoing mental health treatment.

You understand that discussing your disability, symptoms, history, functional limitations, prior accommodations, and testing difficulties may be necessary for the licensed psychologist to make an informed professional determination.

The intake includes anxiety screening for every applicant and may include additional attention, depression, reading and literacy, autism-related, or sensory and medical cognitive-impact screening questions based on the conditions you select. Screening results are one piece of clinical information and are reviewed together with your history, reported functional limitations, requested accommodations, supporting information, and any additional information the psychologist determines is necessary. A screening result does not by itself establish a diagnosis.

Outcomes are not guaranteed. The licensed psychologist will exercise independent professional judgment. If the psychologist determines that documentation is not clinically supported, you will be informed, and you may be eligible for a refund according to our policies.

Client Rights

You have the right to:

• Receive appropriate professional services from the matched licensed psychologist.
• Refuse any service or withdraw consent at any time.
• Receive services without discrimination.
• Be treated with respect and dignity.
• Have your information treated confidentially, with the legal exceptions noted below.
• Be fully informed about fees and payment methods.
• Ask for the full name, license number, licensing jurisdiction, and licensing-board verification information for the psychologist assigned to your evaluation.

Note: Minors 12 and older in California may have specific rights regarding consent under state law.

Confidentiality and Its Limits

Confidentiality between you and the licensed psychologist, and between you and the platform, is maintained except in the following circumstances:

• Reasonable suspicion of child abuse or neglect, which may require reporting to CPS or law enforcement.
• Reasonable suspicion of abuse or neglect of a vulnerable adult, which may require reporting to APS or law enforcement.
• Clear and imminent threat of serious harm to self or others, which may require a duty to warn or protect.
• Court order or legal requirement to release information.
• When you authorize release in writing.
• Consultation with other licensed professionals for quality care or professional guidance, using limited information where appropriate.
• Emergency medical situations requiring intervention or hospitalization.

The platform and licensed psychologist will make reasonable efforts to protect your privacy.

Records, Data Retention, and Privacy

The platform maintains records necessary to facilitate services, including intake information, communications, consent records, billing records, and documentation delivery records. The matched licensed psychologist may maintain their own clinical records as required by applicable law and professional standards.

You have the right to request access to your records, subject to legal limitations. Records are retained in accordance with applicable laws and then securely destroyed.

Risks and Limitations

Discussing your disability, history, and symptoms may cause temporary discomfort. The licensed psychologist will use professional judgment. LSAT accommodation documentation is not guaranteed. Any documentation packet is one part of the evidence reviewed by LSAC or other testing organizations; final decisions rest with them. This service is not a substitute for ongoing mental health treatment if needed.

Licensed Psychologists Only

For LSAT accommodation documentation, LSATaccommodations.com uses fully licensed psychologists only. LSAC Qualified Professional documentation, clinical statements, and accommodation-support documentation are reviewed and signed by a licensed psychologist.

Administrative or customer-support staff may assist with scheduling, intake processing, payment processing, document delivery, and non-clinical communications. Administrative or customer-support staff do not perform clinical evaluations, make clinical determinations, diagnose conditions, recommend accommodations, or sign LSAC Qualified Professional documentation.

Termination and Withdrawal

You may withdraw your consent or discontinue the process at any time. Please notify us or your matched licensed psychologist. We ask for reasonable notice when possible so appropriate closure or referrals can be arranged.

PART 2: HIPAA NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Our Pledge Regarding Your Health Information

We understand that health information about you is personal. We are committed to protecting it. We create records of the services we facilitate and the information you provide. We need this information to match you with an appropriate licensed psychologist, process your requests, deliver documents, and comply with legal requirements.

This Notice applies to records of your care and information handled through LSATaccommodations.com. It describes how we may use and disclose your protected health information, your rights regarding that information, and our legal duties.

We are required by law to:

• Keep your protected health information private.
• Give you this Notice of our legal duties and privacy practices.
• Follow the terms of this Notice that is currently in effect.
• Notify you if we make material changes to this Notice.

How We May Use and Disclose Your Health Information

We may use and disclose your protected health information without your written authorization to carry out treatment, payment, and health care operations, such as matching you with a licensed psychologist, processing payments, delivering documents, quality improvement, platform operations, and customer service.

We may disclose protected health information to the matched licensed psychologist for their professional evaluation and documentation activities.

We may use and disclose your protected health information to remind you of appointments, request intake completion, provide service-related updates, or provide information about related services or benefits we offer.

We may disclose protected health information in response to a court or administrative order, subpoena, or other lawful process, after making reasonable efforts to notify you or obtain a protective order where required.

We may disclose protected health information without authorization when required or permitted by law, including for public health activities, health oversight, law enforcement, coroners, specialized government functions, workers’ compensation, and to avert serious threats to health or safety.

Uses and Disclosures That Require Your Authorization

Most uses and disclosures of psychotherapy notes, if created, marketing purposes involving protected health information, and the sale of protected health information require your written authorization.

We will not sell your protected health information or use your health, disability, intake, screening responses, or clinical documentation information for advertising without your written authorization.

Your Rights Regarding Your Health Information

You have the right to:

• Request restrictions on uses and disclosures of your protected health information.
• Request restrictions for out-of-pocket payments.
• Choose how we communicate with you.
• Inspect and copy your protected health information, with limited exceptions.
• Receive an accounting of disclosures.
• Amend your protected health information.
• Receive a paper or electronic copy of this Notice.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us at info@LSATaccommodations.com or with the Secretary of the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.

Changes to This Notice

We may change the terms of this Notice. The new Notice will be posted on our website and available upon request.

Effective Date of this Notice: June 24, 2026

Acknowledgment

BY CONTINUING TO USE THIS WEBSITE AND CHECKING THE HIPAA ACKNOWLEDGMENT CHECKBOX AT CHECKOUT OR DURING ACCOUNT CREATION, YOU ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD, AND AGREE TO THIS INFORMED CONSENT AND HIPAA NOTICE OF PRIVACY PRACTICES, including all telehealth terms and limitations described above.

You consent to the platform processing your information and matching you with a licensed psychologist, and you consent to receiving clinical assessment and documentation services from the matched independent licensed psychologist via telehealth, secure intake review, phone, video, or other approved remote means.