Privacy Policy

Privacy Policy

If you have any questions, you can contact us using the information provided on our Location page.


Notice of Privacy Practices (NPP) – Brief Version

This notice describes how medical information about you may be used and disclosed, and how you can get access to this information.
Please review it carefully.


Our Commitment to Your Privacy

Our practice is dedicated to maintaining the privacy of your personal health information as part of providing professional care. We are also required by law to keep your information private. These laws are complicated, but we must give you this important information. This handout is a shorter version of a more complete version of the Notice of Privacy Practices (NPP), which is available if you request it. Because we cannot cover all possible situations in this handout, please talk to the Privacy Office about any questions or problems.

We will use the information about health that we get from you or from others mainly to provide you with treatment, to arrange payment for our services, and for some other business activities that are called, in the law, health care operations. Prior to treatment in this office, we will ask you to sign a Consent Form to let us use and share your information. If you do not consent and sign this form, we cannot treat you.

If we or you want to use or disclose (send, share, release) your information for any other purposes, we will discuss this with you and ask you to sign a Release of Information form to allow this.

Of course we will keep your health information private, but there are some times when the laws require us to use or share it. For example:

  1. When there is a serious threat to your health and safety or the health and safety of another individual or the public. We will only share information with a person or organization that is able to help prevent or reduce the threat.
  2. In the case of some lawsuits and legal or court proceedings.
  3. If a law enforcement official requires us to do so.
  4. For Workers Compensation and similar benefit programs.
  5. To protect victims of abuse, neglect or domestic violence.


Your Rights Regarding Your Health Information

You can ask us to communicate with you about your health and related issues in a particular way or at a certain place that is more private for you. For example, you can ask us to call you at home and not at work to schedule or cancel an appointment. We will do our best to comply with your wishes.

You have the right to ask us to limit what we tell people involved in your care or the payment for your care, such as family members and friends. While we don’t have to agree to your request, if we do agree, we will keep our agreement unless it is against the law, or in an emergency, or when the information is necessary to treat you.

You have the right to look at the health information we have about you, such as your medical and billing records.

You do not have the right to look at psychotherapy notes. These notes reflect your therapist’s own considerations and thoughts regarding your treatment and progress. You may obtain a copy of the health information (excluding psychotherapy notes), but we may charge you.

Contact the Privacy Officer to arrange how to see your records.

If you believe the information in your records is incorrect or missing important information, you may ask us to amend it. You will need to make a request in written format and send it to the Privacy Officer. You must tell us the reasons you want to make the changes.

You have the right to request a copy of this notice.

You have the right to file a complaint if you believe your privacy rights have been violated. You can file a complaint with the Privacy Officer and with the Secretary of the Department of Health and Human Services. All complaints must be in written format.

Filing a complaint will not change the health care we provide to you in any way.


If you have any questions regarding this notice or our health information privacy policies, please contact the ‘Privacy Officer’ (your clinician), at (801) 479-8286.


The effective date of this notice is April 14, 2003