Notice of Privacy Practices
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.
My commitment to your privacy
My practice is dedicated to maintaining the privacy of your personal health
information as part of providing professional care. I am also required by law
to keep your information private.
How I use and disclose your protected health information with your
I will use the information I collect about you 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.
Disclosing your health information without your consent
There are some times when the laws require me to use or share your information.
1. When there is a serious threat to your or another’s health and safety or to the
public. I will only share information with persons who are able to help prevent
or reduce the threat.
2.When I am required to do so by lawsuits and other legal or court
3. If a law enforcement official requires me to do so.
4. For workers’ compensation and similar benefit programs.
There are some other rare situations. They are described in the longer version of my notice of privacy practices.
Your rights regarding your health information
1. You can ask me to communicate with you in a particular way or at a certain place that is more private for you. For example, you can ask me to call you at home, and not at work, to schedule or cancel an appointment. I will try my best to do as you ask.
2. You can ask me to limit what I tell people involved in your care or the payment
for your care, such as family members and friends.
3. You have the right to look at the health information I have about you, such as
your medical and billing records. You can get a copy of these records, but I may
charge you for it.
4. If you believe that the information in your records is incorrect or missing
something important, you can ask me to make additions to your records to correct
the situation. You have to make this request in writing and send it to me. You
must also tell me the reasons you want to make the changes.
5. You have the right to a copy of this notice. If I change this notice, I will
post the new version in my office, and you can always get a copy of it from
6. You have the right to file a complaint if you believe your privacy rights have
been violated. You can file a complaint with the Secretary of the U.S.
Department of Health and Human Services. All complaints must be in writing.
Filing a complaint will not change the health care I provide to you in any way.
Also, you may have other rights that are granted to you by the laws of our
state, and these may be the same as or different from the rights described
above. I will be happy to discuss these situations with you now or as they
arise. If you have any questions regarding this notice or my health information
privacy policies, please call (512)704-8349.
The effective date of this notice is January 1st, 2010.
What you Should Know about Confidentiality in Therapy
I will treat what you tell me with great care. My professional ethics (that is, my
profession’s rules about values and moral matters) and the laws of this state
prevent me from telling anyone else what you tell me unless you give me written
permission. These rules and laws are the ways our society recognizes and
supports the privacy of what we talk about—in other words, the “confidentiality” of therapy. However, there are times when the law "requires" me to tell things to others. So please read this information carefully so you have a solid understanding of the limits of confidentiality in therapy.
1. When you or other persons are in physical danger, the law requires me to tell others about it. I am a mandated reporter of abuse. If a minor discloses to me that they have been abused, the incident will be reported to child protective services.
2. In general, if you become involved in a court case or proceeding, there
are some situations where a judge or court may require me to testify. In that
case, you may assert "privilege", which in many cases will not allow me to
3. I am required to keep treatment records.
4. In regard to insurance and money matters, if you use your health
insurance to pay part of my fees, the insurance company, the managed care
organization, or perhaps your employer’s benefits office will require me to
provide information about your functioning.
If you have been sent to me by your employer’s employee assistance
program, the program’s staffers may require some information.
5. Children and families create some special confidentiality questions.
When I treat children under the age of about 12, I must tell their
parents or guardians whatever they ask me. As children grow more able to
understand and choose, they assume legal rights. For those between the ages
of 12 and 18, most of the details in things they tell me will be treated as
confidential. However, parents or guardians do have the right to general
information, including how therapy is going.
The laws and rules on confidentiality are complicated. Please bear in mind that I am not able to give you legal advice. If you have special or unusual concerns, and
so need special advice, I strongly suggest that you talk to a lawyer to
protect your interests legally and to act in your best interests.
"But what I want to assure and reassure the public is we are
concerned about your safety, your security, and your privacy. Let's work
together in partnership to ensure that we can have the best way forward."
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