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

 

The scenarios where we use or share PHI, include:

• Treatment: Sharing information with other professionals involved in the client’s care. This only takes place with explicit consent from the client, except in instances where consent is secondary to a state required breach of confidentiality.

• Payment: Communicating with health insurance companies to process claims.

• Healthcare Operations: Internal administrative, compliance, and quality assessment tasks.

• Required by Law: Situations like mandatory reporting for abuse, or to prevent a serious threat to health or safety.

 

Clients have legal rights regarding their health information, such as:

• The right to inspect and obtain copies of their records (excluding psychotherapy notes).

• The right to request corrections or restrictions on how their data is used.

• The right to request confidential, alternative means of communication.

 

Provider Duties: I am legally required to keep PHI private, follow the terms of the current notice, and notify clients in the event of a data breach.

 

 

Complaints and Contact Information: Clients may contact this provider (or this practice) with questions. If you feel your information has been mishandled or your privacy violated, you have the right to file a formal complaint with the Department of Health and Human Services (HHS) Office for Civil Rights.

 

Effective Date: July 8, 2026