Notice of Privacy Practices

Draft September 21, 2026 · Not yet in force

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

We are required by law to maintain the privacy of your protected health information (PHI), to give you this Notice of our legal duties and privacy practices, and to follow the terms of the Notice currently in effect. We are also required to notify you following a breach of unsecured PHI.

How we may use and disclose your health information without your authorization

Treatment

We may use your PHI to provide, coordinate, or manage your care, and disclose it to other providers involved in your treatment — for example, sending your laboratory results to a specialist.

Payment

We may use and disclose your PHI to obtain payment for services, including billing and collection.

Health care operations

We may use your PHI for quality assessment, staff training and evaluation, licensing, and general business management.

Other permitted or required disclosures

• Appointment reminders and information about treatment alternatives or health-related benefits.
• To persons involved in your care, where you agree or where we may reasonably infer you do not object.
• As required by law; for public health activities; to report abuse, neglect, or domestic violence.
• For health oversight, judicial and administrative proceedings, and law enforcement purposes.
• To coroners, medical examiners, and funeral directors; for organ donation.
• For research approved by an institutional review board or privacy board.
• To avert a serious and imminent threat to health or safety.
• For specialized government functions and as authorized by workers' compensation laws.

Uses and disclosures that require your written authorization

Most uses and disclosures of psychotherapy notes, uses and disclosures for marketing purposes, and any sale of your PHI require your written authorization. Other uses not described in this Notice will be made only with your written authorization, which you may revoke in writing at any time except to the extent we have already acted in reliance on it.

California law provides additional protection for certain categories of information, which may require your specific authorization before disclosure.

Your rights

• Inspect and copy your PHI, including an electronic copy of records we maintain electronically. We may charge a reasonable, cost-based fee.
• Request an amendment if you believe your record is incorrect or incomplete. We may deny the request, and you may file a statement of disagreement.
• Receive an accounting of disclosures we have made, other than for treatment, payment, or health care operations, for the six years before your request.
• Request restrictions on how we use or disclose your PHI. We are not generally required to agree, but we must agree to a request to restrict disclosure to a health plan where you have paid for the service in full out of pocket.
• Request confidential communications at an alternative address or by an alternative means.
• Receive a paper copy of this Notice on request, even if you agreed to receive it electronically.
• Be notified following a breach of your unsecured PHI.

Complaints

You may complain to us using the contact details below, or to the Secretary of the U.S. Department of Health and Human Services, Office for Civil Rights, at hhs.gov/ocr. We will not retaliate against you for filing a complaint.

Changes to this Notice

We reserve the right to change this Notice and to make the revised Notice effective for PHI we already hold as well as information we receive in the future. The current Notice will always be posted on this page with its effective date.