Notice of Privacy Practices

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

• Get a 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 have about you.
• Ask us to correct your medical record — You can ask us to correct health information that you think is incorrect or incomplete.
• Request confidential communications — You can ask us to contact you in a specific way (e.g., home or office phone) or to send mail to a different address.
• 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.
• Get a list of those with whom we've shared information — You can ask for an accounting of the times we've shared your health 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 it electronically.
• Choose someone to act for you — You can give someone medical power of attorney to make choices about your health information.
• File a complaint if you feel your rights are violated — You can complain to us or to the U.S. Department of Health and Human Services Office for Civil Rights.

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.

• Share information with your family, close friends, or others involved in your care
• Share information in a disaster relief situation
• Include your information in a hospital directory
• Contact you for fundraising efforts

In certain cases we will never share your information unless you give us written permission — including marketing purposes, sale of your information, and most sharing of psychotherapy notes.

Our Uses and Disclosures

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

• Treat you — We can use your health information and share it with other professionals treating you.
• Run our organization — We can use and share your health information to run our practice, improve your care, and contact you when necessary.
• Bill for your services — We can use and share your health information to bill and get payment from health plans or other entities.

How Else Can We Use or Share Your Information?

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.

• Help with public health and safety issues
• Conduct research
• Comply with the law
• Respond to organ and tissue donation requests
• Work with a medical examiner or funeral director
• Address workers' compensation, law enforcement, and other government requests
• Respond to lawsuits and legal actions

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.

Changes to the Terms of 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.

Contact Privacy Officer

Privacy contact: Alejandra Pepper — (813) 999-2700