Notice of Privacy Practices

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.

Your rights

When it comes to your health information, you have certain rights. You can:

• Get a copy of your medical record, paper or electronic. We will usually provide it within 30 days and may charge a reasonable, cost-based fee.
• Ask us to correct your record if you think it is incorrect or incomplete. We may say no, but we will tell you why in writing within 60 days.
• Request confidential communications, such as contacting you at a different phone number or address. We will say yes to all reasonable requests.
• Ask us to limit what we use or share. We are not required to agree, except that if you pay for a service out of pocket in full, you can ask us not to share that information with your health insurer.
• Get a list of those with whom we've shared information for up to six years before your request, excluding treatment, payment, operations, and certain other disclosures. One list per year is free.
• Get a copy of this notice on paper at any time, even if you agreed to receive it electronically.
• Choose someone to act for you, such as a medical power of attorney or legal guardian.
• File a complaint if you feel your rights are violated, with us or with the U.S. Department of Health and Human Services Office for Civil Rights (200 Independence Avenue S.W., Washington, D.C. 20201; 1-877-696-6775; hhs.gov/hipaa/filing-a-complaint). We will not retaliate against you for filing a complaint.

Your choices

You can tell us whether to share information with your family, close friends, or others involved in your care, or in a disaster relief situation. If you cannot tell us your preference, for example if you are unconscious, we may share your information if we believe it is in your best interest, or when needed to lessen a serious and imminent threat to health or safety.

We will never share your information for marketing purposes or sell your information unless you give us written permission. Most sharing of psychotherapy notes also requires your written permission.

Our uses and disclosures

• Treatment: sharing information with other professionals who are treating you.
• Running our practice: improving your care, managing operations, and contacting you when necessary.
• Billing: billing and getting payment from health plans and other entities.

We may also share your information when required or permitted by law, including: public health and safety issues (such as reporting adverse reactions or suspected abuse); research under strict conditions; complying with state or federal law; responding to organ and tissue donation requests; working with a medical examiner or funeral director; workers' compensation claims, law enforcement, health oversight agencies, and special government functions; and responding to lawsuits, legal actions, court orders, or subpoenas.

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. You may change your mind at any time by letting us know in writing.

Changes to this notice

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 offices, and on this website.

Questions or complaints