Notice of Privacy Practices

Access Your Health Information

You may ask to see or receive an electronic or paper copy of your medical record and other health information maintained about you.

A copy or summary will generally be provided within the timeframe required by law. A reasonable, cost-based fee may apply where permitted.

Certain information, including psychotherapy notes as defined by law, may be subject to different access rules.

Ask Me to Correct Your Health Information

You may ask me to correct health information that you believe is inaccurate or incomplete.

If I am unable to make the requested change, I will explain the reason in writing within the timeframe required by law.

Request Confidential Communications

You may ask me to contact you in a particular way or at a particular location—for example, by using a specific phone number, email address, or mailing address.

Reasonable requests will be honored.

Ask Me to Limit What I Use or Share

You may ask me not to use or disclose certain health information for treatment, payment, or health care operations.

I am not generally required to agree to every restriction. If I agree, I will follow that restriction except when disclosure is necessary for emergency treatment or otherwise permitted or required by law.

If you pay for a health care service in full out of pocket, you may ask me not to disclose information about that service to your health plan for payment or health care operations. I will honor that request unless disclosure is required by law.

Receive an Accounting of Disclosures

You may request a list of certain disclosures of your health information made during the six years before your request.

This accounting does not include every disclosure. For example, certain disclosures for treatment, payment, health care operations, or disclosures you specifically authorized may not be included.

One accounting during a 12-month period will be provided without charge. A reasonable cost-based fee may apply to additional requests during that period.

Receive a Copy of This Notice

You may request a paper copy of this Notice of Privacy Practices at any time, even if you previously agreed to receive it electronically.

Choose Someone to Act for You

If another person has legal authority to act on your behalf, such as a legal guardian or a person authorized through an appropriate power of attorney, that person may exercise your privacy rights when permitted by law.

I may verify that person's authority before taking action.

File a Complaint

If you believe your privacy rights have been violated, you may contact me directly:

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.

File a HIPAA Privacy Complaint with HHS ↗

You will not be retaliated against for filing a complaint.

People Involved in Your Care

You may tell me whether you want information shared with family members, close friends, or others involved in your care or payment for your care.

If you are unable to communicate your preference, I may share limited information when permitted by law and when I determine that doing so is in your best interest.

Information may also be disclosed when necessary to prevent or lessen a serious and imminent threat to health or safety, as permitted by law.

Written Authorization

Your written authorization is generally required for:

• most uses and disclosures of psychotherapy notes
• marketing purposes when authorization is required by law
• the sale of your health information
• other uses or disclosures not otherwise permitted by law or described in this notice

If you provide written authorization, you may generally revoke it in writing at any time. Revocation will not undo disclosures already made in reliance on your authorization.

The Living Room Therapy + Wellness does not sell your protected health information.

Treatment

I may use your health information to provide therapy and may share appropriate information with other health professionals involved in your care.

For example, with appropriate legal authority, information may be exchanged with another provider to coordinate treatment.

Health Care Operations

I may use or disclose information as necessary to operate the practice, improve services, manage treatment, conduct appropriate professional consultation, and carry out other permitted health care operations.

When consulting with other professionals, I limit identifying information whenever reasonably possible.

Payment

I may use and disclose information as necessary to obtain payment for services.

For clients using out-of-network benefits, this may include information necessary to prepare documentation such as a superbill or to respond appropriately to payment-related requests.

Public Health and Safety

When permitted or required by law, information may be disclosed for certain public health and safety purposes, including:

• reporting suspected abuse or neglect
• preventing or reducing a serious threat to health or safety
• responding to certain public-health requirements
• other disclosures authorized or required by law

Complying With the Law

I will disclose information when federal or state law requires me to do so.

This may include disclosures to the U.S. Department of Health and Human Services for purposes of determining compliance with federal privacy requirements.

Health Oversight and Government Functions

When legally permitted or required, information may be disclosed for purposes including:

• health oversight activities
• workers' compensation matters
• certain law-enforcement requests
• other government functions authorized by law

Legal Proceedings

Health information may be disclosed in response to certain court or administrative orders, subpoenas, or other lawful legal processes, subject to applicable confidentiality protections.

Medical Examiners and Funeral Directors

When permitted by law, health information may be disclosed to coroners, medical examiners, or funeral directors as necessary to carry out their duties.

Research

Health information may be used or disclosed for research only when permitted by applicable law and when required privacy protections have been satisfied.

Organ and Tissue Donation

When applicable and legally permitted, health information may be disclosed to organizations involved in organ, eye, or tissue donation.