Privacy Policy
EFFECTIVE DATE OF THIS NOTICE [2/2/2026]
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.
I. MY PLEDGE REGARDING HEALTH INFORMATION
I understand that health information about you and your health care is personal. I am committed to protecting health information about you. I create a record of the care and services you receive from me. I need this record to provide you with quality care and to comply with certain legal requirements.
This notice applies to all of the records of your care generated by this mental health care practice. This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you, and describe certain obligations I have regarding the use and disclosure of your health information.
I am required by law to:
Make sure that protected health information (“PHI”) that identifies you is kept private.
Give you this notice of my legal duties and privacy practices with respect to health information.
Follow the terms of the notice that is currently in effect.
I can change the terms of this Notice, and such changes will apply to all information I have about you. The new Notice will be available upon request, in my office, and on my website.
II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
The following categories describe different ways that I use and disclose health information. Not every use or disclosure in a category will be listed, but all permitted uses and disclosures will fall within one of these categories.
For Treatment, Payment, or Health Care Operations
Federal privacy rules allow health care providers who have a direct treatment relationship with the patient/client to use or disclose PHI without written authorization for treatment, payment, or health care operations. I may also disclose your PHI for the treatment activities of another health care provider.
For example, if I consult with another licensed health care provider about your condition, I may use and disclose your PHI to assist in diagnosis and treatment.
Disclosures for treatment purposes are not limited to the minimum necessary standard because licensed providers need access to complete information to provide quality care. Treatment includes coordination and management of care, consultations, and referrals.
Lawsuits and Disputes
If you are involved in a lawsuit or legal dispute, I may disclose PHI in response to a court or administrative order. I may also respond to subpoenas or lawful requests, but only if efforts have been made to notify you or obtain an order protecting the information requested.
III. SPECIAL PROTECTIONS FOR SUBSTANCE USE DISORDER (SUD) RECORDS
Some health information related to substance use disorder (SUD) treatment may be subject to additional federal privacy protections under 42 C.F.R. Part 2 (“Part 2”), in addition to HIPAA.
If this practice receives records that are protected by Part 2, those records will be handled in accordance with the stricter federal confidentiality requirements. These records generally may not be used or disclosed unless permitted by law or with your written consent.
Limits on Use of SUD Records in Legal Proceedings
Substance use disorder treatment records protected by Part 2 may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you without your written consent or a court order that meets specific federal requirements, including notice and an opportunity for you to be heard.
IV. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION
Psychotherapy Notes
I do keep “psychotherapy notes” as defined by HIPAA. Any use or disclosure of psychotherapy notes requires your written authorization, except when:
a. Used for your treatment
b. Used for training or supervision
c. Used to defend myself in legal proceedings initiated by you
d. Required for HIPAA compliance investigations
e. Required by law
f. Required for certain health oversight activities
g. Required by a coroner
h. Necessary to prevent a serious threat to health or safety
Marketing Purposes
I will not use or disclose your PHI for marketing purposes.
Sale of PHI
I will not sell your PHI.
V. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION
Subject to legal limitations, I may use or disclose PHI without authorization for:
Disclosures required by law
Public health activities (including abuse reporting and preventing serious harm)
Health oversight activities
Judicial and administrative proceedings
Law enforcement purposes
Coroners or medical examiners
Research purposes
Specialized government functions
Workers’ compensation purposes
Appointment reminders and treatment-related communications
VI. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT
I may disclose PHI to family members, friends, or others involved in your care or payment for care unless you object. In emergency situations, consent may be obtained retroactively.
VII. REDISCLOSURE NOTICE
Health information disclosed in accordance with HIPAA may be subject to redisclosure by the recipient and may no longer be protected by HIPAA privacy rules. However, substance use disorder records protected by federal law may continue to be subject to restrictions on redisclosure.
VIII. YOUR RIGHTS REGARDING YOUR PHI
You have the right to:
Request limits on uses and disclosures of your PHI
Request restrictions for services paid out-of-pocket in full
Request confidential communications
Inspect and obtain copies of your PHI (excluding psychotherapy notes)
Request an accounting of disclosures
Request corrections or amendments to your PHI
Obtain a paper or electronic copy of this Notice
IX. COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with this practice or with the U.S. Department of Health and Human Services, Office for Civil Rights. Filing a complaint will not affect your care in any way.