Notice of Privacy Practices

Effective Date: February 16, 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.

My Commitment to Your Privacy

Your privacy is extremely important. As a licensed mental health provider, I am required by federal law, including HIPAA, to protect your protected health information (“PHI”) and to provide you with this Notice explaining my legal duties and privacy practices.

Protected Health Information (PHI) includes information that identifies you and relates to your mental health condition, treatment, or payment for services.

How I May Use and Disclose Your Information

1. For Treatment

I may use and disclose your PHI to provide, coordinate, or manage your care. This may include consultation with other healthcare providers involved in your treatment (with appropriate consent when required).

2. For Payment

I may use and disclose PHI to obtain payment for services. For example, I may submit information to your insurance company for reimbursement.

3. For Health Care Operations

I may use PHI for administrative purposes such as quality assessment, supervision, licensing requirements, or compliance activities.

Special Protections for Substance Use Disorder Records

If your treatment includes services related to substance use disorders, your records may be protected under federal confidentiality law (42 CFR Part 2).

Under updated 2026 regulations:

• Certain disclosures require your written consent.

• You have the right to revoke consent in writing.

• Unauthorized disclosure of substance use treatment information is prohibited and may be subject to federal penalties.

Where applicable, your records will receive the highest level of confidentiality required by law.

Uses and Disclosures Requiring Authorization

I will obtain your written authorization before:

• Releasing psychotherapy notes (with limited legal exceptions)

• Using your information for marketing purposes

• Disclosing information not otherwise permitted by law

You may revoke your authorization in writing at any time.

Situations Where Disclosure Is Required or Permitted by Law

I may disclose PHI without your authorization in the following circumstances:

• When required by law (court orders, subpoenas)

• To report suspected child abuse, elder abuse, or dependent adult abuse

• If there is a serious threat to your safety or the safety of others

• For certain public health or law enforcement purposes

• For workers’ compensation claims where applicable

I will only disclose the minimum necessary information required by law.

Your Rights Regarding Your Information

You have the right to:

• Access and receive a copy of your health records

• Request corrections to your records

• Request restrictions on certain uses or disclosures

• Request confidential communications (e.g., alternative email or mailing address)

• Receive an accounting of disclosures

• Receive a paper or electronic copy of this Notice at any time

If you believe your privacy rights have been violated, you may file a complaint with me directly or with the U.S. Department of Health and Human Services Office for Civil Rights. Filing a complaint will not affect your care.

My Responsibilities

I am required by law to:

• Maintain the privacy of your PHI

• Provide you with this Notice

• Follow the terms of this Notice

• Notify you in the event of a breach of unsecured PHI

I reserve the right to change this Notice. Any changes will apply to all records I maintain and will be posted on my website with a revised effective date.