HIPAA Notice of Privacy Practices

Your Rights

• Get a copy of your medical record: You can ask to see or receive a copy of your health record. We may charge a reasonable fee.
• Request corrections: If you believe information in your record is incorrect or incomplete, you may request an amendment.
• Request confidential communications: You may ask us to contact you in a specific way (e.g., at work or by mail).
• Request restrictions: You may request that we not share certain health information, though we may not always be able to agree if it affects your care or we are legally required to share it.
• Get a list of disclosures: You may request a list of when and with whom your information was shared, except for routine disclosures (e.g., treatment, payment, operations).
• Choose a representative: If you have given someone medical power of attorney or are a legal guardian, that person can exercise your rights.
• File a complaint: If you believe your privacy rights have been violated, you can file a complaint with us or with the U.S. Department of Health and Human Services (HHS). You will not be penalized for filing a complaint.

Our Uses and Disclosures

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

• For treatment: To provide, coordinate, or manage your mental health care.
• For payment: To bill and receive payment from insurance or other payors.
• For healthcare operations: To improve services, train staff, and ensure quality of care.

Other disclosures may include:

• Public health and safety: Reporting suspected abuse, neglect, or certain diseases.
• Law enforcement and legal requirements: Responding to court orders, subpoenas, or legal processes.
• Research (with safeguards): We may use information for research if approved by an institutional review board.
• Workers’ compensation, health oversight, and specialized government functions: As permitted or required by law.

We will never sell your health information or use it for marketing without your written authorization.

Our Responsibilities

• We are required by law to maintain the privacy and security of your Protected Health Information (PHI).
• We will let you know promptly if a breach occurs that may compromise the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice.
• We will not use or share your information other than as described here unless you provide written permission. If you do, you may revoke that permission at any time.

Changes to This Notice

We may change this notice at any time, and the new notice will apply to all information we have about you. Updated notices will be available at our office and on our website.

Contact Us

If you have questions, want to exercise your rights, or wish to file a complaint, please contact:

You may also file a complaint directly with the U.S. Department of Health and Human Services, Office for Civil Rights: