Privacy Policy

1. Your Rights:

This section explains your rights regarding your protected health information and some of our responsibilities to help you:

• Get an electronic or paper copy of your medical record.

  • You can ask to see or get an electronic or paper copy of your medical record and other health information.

  • We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

• Ask us to correct your medical record.

  • You can ask us to correct health information about you that you think is incorrect or incomplete.

  • We may say “no” to your request, but we’ll tell you why in writing within 60 days.

• Request confidential communications.

  • You can ask us to contact you in a specific way (for example, cell or office phone) or to send mail to a different address.

  • We will say “yes” to all reasonable requests.

• Ask us to limit what we use or share.

  • You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.

  • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

• Get a list (accounting) of those with whom we’ve shared information.

• Get a copy of this privacy notice

  • You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

• Choose someone to act for you

  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

  • We will make sure the person has this authority and can act for you before we take any action.

• File a complaint if you feel your rights are violated

  • You can complain if you feel we have violated your rights by contacting us

  • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights

  • We will not retaliate against you for filing a complaint.

2. Your Choices:

• For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

  • In these cases, you have both the right and choice to tell us to:

    • Share information with your family, close friends, or others involved in your care by giving written permission via the Release of Information form

    • Share information in a disaster relief situation

    • If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

  • In the case of psychotherapy notes and treatment plans we never share your information unless you give us written permission

• Please note that electronic forms of communication such as email, fax, cell phone calls, and text messages cannot be guaranteed to be secure and confidential. Please keep this in mind when choosing to use these forms of communication with your psychotherapist.

3. Our Uses and Disclosures:

• We typically use or share your health information in the following ways:

  • To treat you: we can use your health information and share it with other professionals who are treating you with your written permission via the Release of Information form

    • Example: A therapist treating you for a mental health condition speaks with your psychiatrist to compare diagnoses

  • To run our organization: we can use and share your health information to run our practice, improve your care, and contact you when necessary.

    • Example: We use health information about you to seek consultation with other professionals within our practice in order to improve the quality of care you receive

  • To bill for your services: we can use and share your health information to bill and get payment from health plans or other entities.

    • Example: We give information to your health insurance plan to seek payment for services.

• We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov

  • Help with public health and safety issues: we can share health information for certain situations:

    • Reporting suspected abuse, neglect, or domestic violence

    • Preventing or reducing a serious imminent threat to anyone’s health or safety

  • Do research: we can use or share your information for health research.

  • Comply with the law: we will share information about you if state or federal laws require it, including with the Department of Health and Human Services to comply with federal privacy law.

  • Work with a medical examiner or funeral director.

  • Address workers’ compensation, law enforcement, and other government requests.

  • Respond to lawsuits and legal actions: we can share health information about you in response to a court or administrative order, or in response to a subpoena.

• We never market or sell your protected health information

4. Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.

• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

• We must follow the duties and privacy practices described in this notice and give you a copy of it.

• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

• We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.