(Updated 2026)

THIS NOTICE DESCRIBES HOW MEDICAL AND MENTAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

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I. Our Commitment to Your Privacy

We are committed to protecting the privacy and confidentiality of your protected health information (PHI). We create and maintain records of the care and services you receive in order to provide you with quality treatment and to comply with legal and regulatory requirements.

We are required by law to:

• Maintain the privacy of your PHI;

• Provide you with this Notice of our legal duties and privacy practices;

• Follow the terms of this Notice currently in effect.

We reserve the right to revise this Notice at any time. Any updates will apply to all PHI we maintain. The most current version will be available in our office and on our website.

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II. How We May Use and Disclose Your Health Information

We may use or disclose your PHI without your written authorization for the following purposes:

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Treatment, Payment, and Health Care Operations

We may use or share your information to:

• Coordinate or manage your care with other health care providers;

• Bill and receive payment for services provided;

• Conduct internal operations such as quality assurance, training, and administrative activities.

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Legal Proceedings

We may disclose your PHI in response to a court or administrative order. We may also respond to subpoenas or other lawful requests after making reasonable efforts to notify you or obtain protective measures when appropriate.

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III. Uses and Disclosures Requiring Your Written Authorization

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Psychotherapy Notes

Psychotherapy notes, as defined under federal law (45 CFR §164.501), will not be disclosed without your written authorization except:

• For treatment purposes by the provider who created the notes;

• For supervision or training;

• To defend against legal action brought by you;

• As required by the Department of Health and Human Services;

• As otherwise required by law.

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Marketing and Sale of Information

We will not use or disclose your PHI for marketing purposes or sell your PHI without your explicit written authorization.

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IV. Uses and Disclosures Permitted Without Authorization

We may use or disclose your PHI without your authorization when required or permitted by law, including but not limited to:

• Public health reporting (e.g., abuse, neglect, communicable diseases);

• Health oversight activities (audits, investigations);

• Law enforcement purposes;

• Court orders or legal subpoenas;

• Coroners or medical examiners;

• Research under approved conditions;

• Specialized government functions (e.g., national security, military);

• Workers’ compensation claims;

• Appointment reminders and treatment alternatives.

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V. Disclosures Involving Others in Your Care

We may share relevant information with family members, friends, or others involved in your care or payment for care when appropriate, unless you object. In emergency situations, we may share information when necessary to prevent harm, with the opportunity for you to object when feasible.

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VI. Your Rights Regarding Your Health Information

You have the right to:

Request Restrictions

Request limits on how your PHI is used or disclosed. We will consider all reasonable requests.

Request Confidential Communications

Ask us to contact you in a specific way or at a specific location.

Access and Obtain Copies

Request access to or copies of your PHI (excluding psychotherapy notes). We will respond within 30 days, and a reasonable fee may apply.

Request an Accounting of Disclosures

Receive a list of certain disclosures made in the past six years.

Request Amendments

Request corrections to your PHI if you believe it is inaccurate or incomplete. If denied, you will receive a written explanation.

Obtain a Copy of This Notice

You may request a paper or electronic copy of this Notice at any time.

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VII. Changes to This Notice

We reserve the right to update this Notice at any time. Updated versions will apply to all PHI we maintain.

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VIII. Acknowledgment of Receipt

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have rights regarding your protected health information.

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At intake, you acknowledge that you have received, read, and understand this Notice of Privacy Practices. , and agree to the policies outlined in this document.