This notice describes how patient information may be used and disclosed and how to access this information. When it comes to health information, patients have certain rights. This notice explains patient rights and some psychologist responsibilities to help patients.
Patient Rights
Receive an electronic or paper copy of the medical record. Requests may be made to see or receive an electronic or paper copy of medical records and other health information. A copy or a summary will be provided usually within 30 days.
Ask to correct medical record. Requests may be made to correct health information thought to be incorrect or incomplete. Requests may be denied, in which case written explanation will be provided within 60 days.
Request confidential communications. Requests may be made for specific forms of contact (for example, home or office phone) or to receive mail at a different address. All reasonable requests will be approved.
Request to limit what is used or shared. Requests can be made to not use or share certain health information for treatment, payment, or operations. Requests may be rejected if they would affect patient care.
Receive a copy of this privacy notice. A paper copy of this notice can be requested at any time, even if it has been provided electronically. A paper copy will be provided promptly.
File a complaint if patient rights were violated. Complaints can be filed with the US Department of Health and Human Services Officer for Civil Rights by sending a letter to 200 Independence Ave SW, Washington, DC 20201, calling 1-877-696-6775, or visiting https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf Psychologists will not retaliate in response to complaints.
Patient Choices
For certain health information, what is shared is a choice. Make known clear preferences for how information is shared in the situations described below. Instructions will be followed.
In these cases, patients and legal caregivers have rights and choices to have information shared: with family, close friends, or others involved in the care; and in disaster relief situations. Information may be shared if needed to lessen a serious and imminent threat to health or safety.
Information is never sold or used for marketing. Psychotherapy notes are not created or maintained at this practice.
Other uses and disclosures:
How is health information typically shared? Typically, information is shared or used in the following ways:
To treat. Health information can be shared with other professionals treating the patient.
To run the practice. Health information can be used to run the practice, improve patient care, and make necessary contacts.
How else can health information be shared or used? Information sharing is allowed or required in ways that contribute to public health. Many conditions in the law need to be met before information can be shared for these purposes. More information provided by HHS at https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html.
Help with public safety issues. Health information can be shared for certain situations such as reporting suspected abuse or neglect, or preventing or reducing a serious threat to anyone’s health or safety.
Comply with the law. Information will be shared if required by state or federal law, including with the Department of Health and Human Services if it wants to see that federal privacy laws are being followed.
Respond to lawsuits and legal actions. Health information can be shared in response to a court order or subpoena.
Psychologist Responsibilities
The law requires maintenance of privacy and security of protected health information. Patients and legal caregivers will be contacted promptly if a breach occurs that may have compromised their privacy or security. Duties and privacy practices described in this notice must be followed and copies must be provided. Information will not be used or shared other than as described here unless a written request is submitted. If information sharing is requested, the patient or legal caregiver may change their mind at any time. Notifications of changes must be written. For more information, visit https://www.hhs.gov/hipaa/for-individuals/notice-privacy-practices/index.html.
Changes to the Terms of This Notice: Changes will apply to all information. New notices will be available upon request and on this site.