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.

I. OUR COMMITMENT TO PROTECTING YOUR HEALTH INFORMATION: We understand that your health information is personal, and we are dedicated to safeguarding it. We maintain records of the care and services you receive from us to provide quality care and comply with legal requirements. This notice applies to all records of your care generated by our mental health care practice. It outlines how we may use and disclose your health information, your rights regarding the information, and our obligations concerning its use and disclosure.

II. HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION: We use and disclose your health information in various ways for treatment, payment, and health care operations. Treatment may involve consultations with other health care providers, referrals, and coordination of care. We may disclose health information as required by state or federal law, for public health activities, health oversight activities, legal proceedings, law enforcement purposes, research (with appropriate protections), and other specialized government functions.

III. SPECIAL CASES REQUIRING YOUR AUTHORIZATION: Certain uses and disclosures of psychotherapy notes require your authorization unless specified circumstances apply, such as treatment, training, legal defense, compliance investigations, or situations mandated by law. We do not use your health information for marketing purposes or sell it as part of our regular business operations.

IV. USES AND DISCLOSURES NOT REQUIRING YOUR AUTHORIZATION: There are situations where we may use and disclose your health information without your authorization, such as complying with state or federal law, public health activities, health oversight activities, judicial and administrative proceedings, law enforcement purposes, and for appointment reminders or informing you about treatment alternatives or health care services.

V. OPPORTUNITY TO OBJECT TO DISCLOSURES TO FAMILY, FRIENDS, OR OTHERS: We may disclose your health information to family members, friends, or others involved in your care or payment for your health care, unless you object. In emergency situations, we may obtain your retroactive consent.

VI. YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION: You have several rights regarding your health information, including the right to request limits on certain uses and disclosures, restrictions on out-of-pocket expenses, preferred methods of communication, access to and copies of your records, a list of disclosures made, correction or update of your information, and obtaining a paper or electronic copy of this notice.

EFFECTIVE DATE OF THIS NOTICE: This notice went into effect on 08/23/22. By acknowledging receipt of this notice, you confirm that you have read and understood the HIPAA Notice of Privacy Practices.

Acknowledgement of Receipt of Privacy Notice: Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have certain rights regarding the use and disclosure of your protected health information. By checking the box below, you are acknowledging that you have received a copy of the HIPAA Notice of Privacy Practices.