Notice of Privacy Practices

This notice describes how treatment information about you may be used and disclosed and how you can get access to this information.

Right to Privacy
Health care providers are required by federal and state law to maintain the privacy of your treatment information. We are also required to give you notice about our privacy practices, our legal duties and your rights concerning your treatment information.

I must follow the privacy practices that are described while it is in effect. I reserve the right to change your privacy practices and the terms of this notice at any time provided such changes are permitted by applicable law. You may request a copy of the notice at any time from me.

Uses and Disclosures of Treatment Information
I will use information about your health care to provide you with treatment, to arrange payment for my services and in conjunction with other health care providers, organizations, and other professionals. The information privacy practices in this notice will be followed by any associate involved in your care and any business associate with whom I share health Information.

The following categories describe examples of the way I use and disclose treatment information.

For Treatment: I may discuss your treatment information with another mental health professional. For example, I may provide information to your health plan providers to arrange for a referral or consultation but only with your express permission.

For Payment: I may use and disclose your treatment information to obtain payment services I provide you, including but not limited to business in connection with billing and collection activities. For example, I may contact your insurer to verify benefits and obtain prior authorization to make sure they will pay for your care.

Legal Proceedings: I may disclose information in response to a court or administrative order, subpoena, discovery request or other lawful process under certain circumstances. I may disclose your treatment to appropriate authorities if I reasonably believe you are a possible victim of abuse, neglect, or domestic violence or the possible victim of other crimes, I may disclose information to the extent necessary to protect your health or safety or the health or safety of others.

I will not disclose your treatment information if that disclosure is prohibited or significantly limited by other applicable law.

Use of Email and Text Message:
These are not secure forms of relaying health information back and forth, so if we are using them they will be used to talk about scheduling or cancellations. However, if we do need to use these forms of communication I will do my best to keep information private. Best practices include using the HIPAA compliant platform of Simple Practice for telehealth sessions. Signing this will also give me consent to use text and email for other forms of communication if you (the client or guardian) deem them acceptable and feel comfortable knowing these forms of communication are not HIPAA compliant.