NOTICE OF PRIVACY PROTECTION
In compliance with the Health Information Portability and Accountability Act (HIPAA)

This notice describes how psychological and medical information about you can be used and disclosed and how your rights are protected.

Uses and disclosures for treatment, payment and health care operations that require your written authorization:
Protected Health Information (PHI) includes identification information, session dates, practice codes and charges that is released about you to other parties such as for insurance reimbursement or professional consultation, etc., with your authorization.

Authorizations are signed legal documents that are in effect for one year. They can be revoked by written request, unless it has been obtained as a condition of insurance reimbursement or if action has been taken in reliance on the authorization. When you sign an insurance form it is considered authorization to release PHI.

Use of Psychotherapy Notes:
Psychotherapy notes are notes I have made about our conversations during sessions or over the telephone and that I keep separate from the rest of your record. They are not included in PHI and are given a greater degree of protection than PHI. Access to my psychotherapy notes is forbidden.

Uses and disclosures that do not require your authorization:
Although access to my psychotherapy notes is forbidden, there are arrow exceptions to this protection, including reporting laws (e.g., child abuse), disclosures necessary to prevent harm to the patient or others, supervision for training purposes within the abmit of confidentiality, defense against litigation by the patient, investigation by a medical examiner to determine the cause of death of the patient, health care practice oversight (investigation of the therapist), and disclosures authorized by the patient. The patient does not have the right to read, amend, or have a copy of psychotherapy notes.

Patient's rights:

• Right to request restrictions: however, I am not required to agree to the request
  
• Right to receive confidential communications by alternative means and at alternative locations (bills, reports, etc.)
  
• Right to inspect and copy PHI for as long as the information is maintained in the record
  
• Right to amend PHI for as long as it is maintained in the record; however, I may deny your request
  
• Right to an accounting of the disclosures of PHI
  
• Right to a paper copy of this notice
  
• Right to notice of changes to these privacy policies through mail, posting, or website
  
• If you feel that your privacy rights have been violated, you may discuss it with me and/or send a written complaint to me.