Privacy Policy

I recognize that your health information is deeply personal and private. I am dedicated to safeguarding all health information about you. I maintain records of the care and services I provide to ensure you receive quality treatment and to meet legal obligations. This notice covers all records created by this mental health practice regarding your care.

​

This notice explains how I may use and share your health information. It outlines your rights concerning the health information I maintain about you and describes my legal responsibilities for using and disclosing your health information. Federal law requires me to:

​

Ensure that protected health information ("PHI") identifying you remains confidential.

Provide you with this notice explaining my legal responsibilities and privacy practices regarding your health information.

Adhere to the terms outlined in the notice currently in effect.

I may modify the terms of this notice, and any changes will apply to all health information I maintain about you. Updated notices will be available upon request at my office and on my website.

​

HOW I MAY USE AND DISCLOSE YOUR HEALTH INFORMATION:

The categories below describe various ways I use and disclose health information. For each category, I will explain the meaning and provide examples when possible. While not every specific use or disclosure within a category is listed, all permitted uses and disclosures will fall within one of these categories.

​

For Treatment, Payment, or Health Care Operations: Federal privacy regulations permit health care providers with direct treatment relationships to use or disclose patient health information without written authorization for their own treatment, payment, or health care operations. I may also disclose your protected health information to support the treatment activities of other health care providers without requiring your written authorization. For instance, if I consult with another licensed health care provider about your condition, I am permitted to use and disclose your otherwise confidential personal health information to assist in diagnosing and treating your mental health condition.

​

Treatment-related disclosures are not subject to minimum necessary standards because therapists and other health care providers require access to complete records and comprehensive information to deliver quality care. "Treatment" encompasses the coordination and management of care among health care providers and third parties, consultations between providers, and referrals from one health care provider to another.

​

Lawsuits and Disputes: If you become involved in a lawsuit, I may disclose health information in response to a court or administrative order. I may also disclose health information about you in response to a subpoena, discovery request, or other lawful process initiated by someone else involved in the dispute, but only after efforts have been made to notify you about the request or to obtain a protective order for the requested information.

​

CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:

Subject to certain legal limitations, I can use and disclose your PHI without your authorization for the following reasons:

​

When disclosure is required by state or federal law, with use or disclosure limited to and complying with the relevant legal requirements.

​

For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing serious threats to anyone's health or safety.

​

For health oversight activities, including audits and investigations.

​

For judicial and administrative proceedings, including responding to court or administrative orders, though I prefer to obtain your authorization before doing so.

​

For law enforcement purposes, including reporting crimes that occur on my premises.

​

To coroners or medical examiners when they are performing legally authorized duties.

​

For research purposes, including studies comparing the mental health outcomes of patients who received different forms of therapy for the same condition.

​

For specialized government functions, including ensuring proper execution of military missions, protecting the President of the United States, conducting intelligence or counter-intelligence operations, or helping ensure safety of those working in or housed within correctional institutions.

​

For workers' compensation purposes. While I prefer to obtain your authorization, I may provide your PHI to comply with workers' compensation laws.

​

For appointment reminders and health-related benefits or services. I may use and disclose your PHI to contact you about upcoming appointments. I may also use and disclose your PHI to inform you about treatment alternatives or other health care services or benefits I offer.

​

CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT:

Disclosures to family, friends, or others. I may share your PHI with a family member, friend, or other person you identify as involved in your care or payment for your health care, unless you object in whole or in part. In emergency situations, I may obtain your consent retroactively.

​​

YOU HAVE THE FOLLOWING RIGHTS REGARDING YOUR PHI:

The Right to Request Limits on Uses and Disclosures of Your PHI. You may ask me not to use or disclose certain PHI for treatment, payment, or health care operations purposes. I am not required to agree to your request and may decline if I believe it would negatively affect your health care.

​

The Right to Request Restrictions for Out-of-Pocket Expenses Paid in Full. You may request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI relates solely to a health care item or service you have paid for out-of-pocket in full.

​

The Right to Choose How I Send PHI to You. You may ask me to contact you in a specific way (such as home or office phone) or to send mail to a different address. I will agree to all reasonable requests.

​

The Right to See and Get Copies of Your PHI. 

​

The Right to Get a List of the Disclosures I Have Made. You may request a list of instances when I have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided authorization. I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list will include disclosures made in the last six years unless you request a shorter period. I will provide the first list at no charge, but if you make more than one request in the same year, I will charge you a reasonable cost-based fee for each additional request.

​

The Right to Correct or Update Your PHI. If you believe there is a mistake in your PHI or that important information is missing, you may request that I correct the existing information or add the missing information. I may decline your request, but I will explain why in writing within 60 days of receiving your request.

​

The Right to Get a Paper or Electronic Copy of this Notice. You have the right to obtain a paper copy of this notice and to receive a copy by email. Even if you have agreed to receive this notice via email, you also have the right to request a paper copy.

​

EFFECTIVE DATE OF THIS NOTICE:

This notice became effective on 01/01/2026.

​

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have specific rights regarding the use and disclosure of your protected health information. By signing this form, you acknowledge that you have received a copy of the HIPAA Notice of Privacy Practices.

​

​