Privacy Practices - Health Insurance Portability and Accountability Act (HIPAA)


When it comes to your health information, you have the right to: Obtain an electronic or paper copy of your medical record; Ask me to correct your medical record; Request confidential communication; Ask me to limit what I use or share; Get a list of those with whom I've shared information; Get a copy of this privacy notice; Choose someone to act for you; File a complaint if you feel that your rights have been violated.


You have both the right and the choice to tell me with whom you wish to share information: your family, friends, or others involved in your care; and/or, under circumstances of disaster relief or other emergencies. I will never share your information for marketing purposes or sales of any kind.

Uses and Disclosures

We use your information to treat you, to run the practice, to bill for services, and to *comply with the law and respond to lawsuits and legal actions, if necessary.


I am required by law to maintain the privacy and security of your protected health information. I will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. I must follow the duties and privacy practices described in this notice and give you a copy of it. I will not use or share your information other than as described here unless you tell me I can, in writing. If you tell me I can, you may change your mind at any time. Let me know, in writing, if you change your mind.

Changes to the Terms of This Notice

I can change the terms of this notice, and the changes will apply to all information I have about you. The new notice will be available upon request, in my office, and on my website.

*I do not create or maintain psychotherapy notes at this practice.

Effective date of this notice: September 23, 2013.