Privacy Policy

Notice of Privacy Practices

This notice describes how your health information may be used and disclosed, and how you can access this information. Please review it carefully. You may have additional rights under state and local laws. Please consult with legal counsel licensed in your state if you have questions regarding your healthcare information rights.

Effective Date of this Notice
This notice went into effect on 09/01/2022.

Acknowledgement of Receipt of Privacy Notice
Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have rights regarding the use and disclosure of your protected health information (PHI).

I. My Pledge Regarding Health Information

Your health information and care are personal, and protecting it is my commitment. I create and maintain records of the services you receive to ensure quality care and compliance with legal requirements. This notice applies to all care records generated by this mental health practice. Here’s how I am committed to handling your information:

• Privacy: I will ensure the privacy of your PHI.

• Transparency: I will provide this notice, detailing my privacy practices.

• Legal Compliance: I will follow the terms of this notice and make updated versions available.

II. How I May Use and Disclose Health Information

Treatment, Payment, or Health Care Operations

HIPAA permits healthcare providers to use or disclose PHI without written authorization for treatment, payment, or operations. For instance, your PHI may be used for treatment purposes, including consultations with other providers, and operational activities like billing or sending reminders.

Legal Situations

In lawsuits or disputes, health information may be disclosed in response to a court or administrative order, or as required by subpoena.

III. Certain Uses and Disclosures Requiring Authorization

• Psychotherapy Notes: Use or disclosure of psychotherapy notes requires authorization, except in specific instances, such as for treatment purposes or legal compliance.

• Marketing: Your PHI will not be used for marketing without prior written consent.

• Sale of PHI: I do not sell your PHI.

IV. Uses and Disclosures That Do Not Require Your Authorization

In specific cases outlined by law, I may use and disclose your PHI without authorization, including for appointment reminders, public health purposes, health oversight activities, legal requirements, law enforcement purposes, research, and other specialized government functions.

V. Certain Uses and Disclosures Allow You to Object

You have the right to object to disclosures to family, friends, or others involved in your care, except in emergencies or when required for safety.

VI. Your Rights Regarding Your PHI

1. Request Restrictions: You may request limits on uses and disclosures.

2. Limit Disclosures for Out-of-Pocket Payments: You may restrict disclosure to health plans for items or services paid out-of-pocket.

3. Request Communication Preferences: Specify preferred contact methods.

4. Access Your PHI: Obtain a copy of your records.

5. Accounting of Disclosures: Request a list of non-treatment or payment-related disclosures.

6. Amend Your PHI: Correct or add missing information.

7. Request a Copy of This Notice: Available in paper or digital format.

8. Appoint Someone to Act on Your Behalf: Specify authorized individuals.

9. Revoke an Authorization: Withdraw authorizations at any time.

10. Opt Out of Communication: Limit communication preferences.

11. File a Complaint: Report HIPAA violations to HHS if necessary.

VII. Changes to This Notice

This policy may be updated, with new versions available upon request, at the office, and on the website.

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If you have questions or need further assistance, please reach out.