HIPAA Notice of
Privacy Practices

We are required by law to:

• Maintain the privacy of your protected health information (PHI)
• Provide you with this notice of our privacy practices
• Follow the terms of this notice currently in effect
• Notify you in the event of a breach of your unsecured PHI

We reserve the right to change this notice at any time and to make the revised notice effective for protected health information we already hold as well as any new information we receive after the revision date. If we make a material change, the revised notice will be posted in our office and on this website.

We may use and disclose your protected health information for the following primary purposes without your written authorization:

We may also use or disclose your PHI without your authorization when required or permitted by law, including: public health activities, reporting abuse or neglect, health oversight activities, court proceedings, law enforcement purposes, and to prevent a serious threat to health or safety.

You have the following rights with respect to your protected health information:

Right to Access. You have the right to request and receive a copy of your medical records and other PHI that we maintain. We may charge a reasonable fee for copies. We will respond to your request within 30 days.

Right to Amendment. If you believe that information we have about you is incorrect or incomplete, you may request that we amend it. We are not required to agree to the amendment, but we will review your request and respond in writing.

Right to an Accounting of Disclosures. You have the right to receive a list of certain disclosures we have made of your PHI in the six years prior to your request, other than those made for treatment, payment, or healthcare operations.

Right to Request Restrictions. You may ask us to limit how we use or disclose your PHI for treatment, payment, or healthcare operations. We are not required to agree to your request, except in certain limited circumstances. If we do agree, we will honor the restriction unless it is needed to provide emergency treatment.

Right to Confidential Communications. You may request that we communicate with you about your health matters in a particular way or at a specific location. For example, you may ask that we only contact you at home or by email. We will accommodate reasonable requests.

Right to a Paper Copy. You have the right to request a paper copy of this notice at any time, even if you received it electronically.

Right to File a Complaint. If you believe your privacy rights have been violated, you may file a complaint with our practice or with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

We will obtain your written authorization before using or disclosing your PHI for any purpose not covered by this notice, including:

• Most uses and disclosures of psychotherapy notes
• Uses and disclosures of PHI for marketing purposes
• Disclosures that constitute a sale of your PHI
• Other uses and disclosures not described in this notice

You may revoke any written authorization at any time by submitting a written revocation to our office, except to the extent we have already taken action in reliance on the authorization.

Certain categories of health information receive additional protection under federal and state law. We will comply with all applicable requirements when using or disclosing information related to:

• Mental health and substance use disorders
• HIV/AIDS status
• Genetic information (GINA)
• Reproductive health services

For questions, concerns, or to exercise any of the rights described in this notice, contact our Privacy Officer: