Notice of Privacy Practices

EFFECTIVE DATE OF THIS NOTICE: 10/2/25

This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you, and describe certain obligations I have regarding the use and disclosure of your health information.

Mental Health Medical Records is the term used for my formal record of the services provided to you, and contain the dates of our sessions, your diagnosis, functional status, symptoms, prognosis and progress, and any psychological testing reports "Psychotherapy notes" are notes I have made about our conversation during a private, group, joint, or family counseling session, which I have kept separate from the rest of your medical record. Under HIPAA Regulations, such notes are given a greater degree of protection than the PHI or formal record, and they are considered my own private communication. However, Virginia law does not make this distinction, and these are included in the category of "protected health information: which can be released without your consent in circumstances such as those described in the next section. 

This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you, and describe certain obligations I have regarding the use and disclosure of your health information.

I.  MY PLEDGE REGARDING HEALTH INFORMATION:
I understand that health information about you and your health care is personal. I am committed to protecting health information about you. This notice applies to all of the records of your care generated by this mental health care practice. 

I am required by law to:

  • Make sure that protected health information (“PHI”) that identifies you is kept private.

  • Give you this notice of my legal duties and privacy practices with respect to health information.

  • Follow the terms of the notice that is currently in effect.

II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:

The following categories describe different ways that I use and disclose health information. For each category of uses or disclosures I will explain what I mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways I am permitted to use and disclose information will fall within one of the categories.

II. A. Limits of Confidentiality:

Subject to certain limitations in the law, I can use and disclose your PHI without your Authorization or consent for the following reasons:

  • Emergency: If you are involved in a life-threatening emergency and I cannot ask your permission, I will share information if I believe you would have wanted me to do so, or if I believe it will be helpful to you.

  • Child Abuse Reporting: If I have reason to suspect that a child is abused or neglected, I am required by law to report the matter immediately to the Virginia Department of Social Services.  

  • Adult Abuse Reporting: If I have reason to suspect that an elderly or incapacitated adult is abused, neglected or exploited, I am required by law to immediately make a report and provide relevant information to the Virginia Department of Welfare or Social Services.  

  • Health Oversight: Virginia law requires that I report misconduct by a health care provider of my own profession. By policy, I also reserve the right to report misconduct by health care providers of other professions. By law, I am required to explain to you how to make such a report if you describe unprofessional conduct by another mental health provider. If you are yourself a health care provider, I am required by law to report that you are in treatment if I believe that your condition places the public at risk. Virginia Licensing Boards have the power, when necessary, to subpoena relevant records. 

  • Court Proceedings: If you are involved in a court proceeding and a request is made for information about your diagnosis and treatment and the records thereof, such information is privileged under state law, my preference is to obtain an Authorization from you before doing so or to receive a court order. If I receive a subpoena for records or testimony, I will notify you and you can file a motion to quash (block) the subpoena. However, while awaiting the judge's decision, I am required to place said records in a sealed envelope and provide them to the Clerk of Court of the appropriate jurisdiction. In Virginia, parents' therapy records may not be used as evidence in child custody cases. However, therapy information or records are not protected by patient-therapist privilege in child abuse cases, in cases in which your mental health is an issue (e.g., if you sue someone for mental/emotional damages), or in any case in which the judge deems the information to be “necessary for the proper administration of justice.” Virginia has no statute granting therapist-client privilege in criminal cases. The protections of privilege also do not apply if I do an evaluation for a third party or where the evaluation is court ordered. You will be informed in advance if this is the case.  

  • Serious Threat to Health or Safety: Under Virginia law, if I am engaged in my professional duties and you communicate to me a specific and immediate threat to cause serious bodily injury or death, to an identified or to an identifiable person, and I believe you have the intent and ability to carry out that threat immediately or imminently, I am legally required to take steps to protect third parties. These precautions may include 1) warning the potential victim(s), or the parent or guardian of the potential victim(s), if under 18, 2) notifying a law enforcement officer, or 3) seeking your hospitalization. By policy, I may also use and disclose medical information about you when necessary to prevent an immediate, serious threat to your own health and safety. 

  • Workers Compensation: If you file a worker's compensation claim,I am required to provide your PHI in order to comply with workers’ compensation laws although my preference is to obtain an Authorization from you first.

  • Records of Minors: Virginia has a number of laws that limit the confidentiality of the records of minors. Such circumstances will be discussed further if services are being provided to a minor.

  • For Treatment Payment, or Health Care Operations: Federal privacy regulations allow health care providers who have a direct treatment relationship with the patient/client to use or disclose the patient/client’s personal health information without the patient’s written authorization, in order to carry out the health care provider’s own treatment, payment or health care operations. I may also disclose your protected health information for the treatment activities of any health care provider. This too can be done without your written authorization though my preference is to obtain your prior authorization. For example, if a clinician were to consult with another licensed health care provider about your condition, we would be permitted to use and disclose your personal health information, which is otherwise confidential, in order to assist the clinician in diagnosis and treatment of your mental health condition. Disclosures for treatment purposes are not limited to the minimum necessary standard,  because therapists and other health care providers need access to the full record and/or full and complete information in order to provide quality care. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers and referrals of a patient for health care from one health care provider to another.

III. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:

  • The Right to Request Limits on Uses and Disclosures of Your PHI: You have the right to request restrictions on certain uses and disclosures of protected health information about you. You also have the right to request a limit on the medical information I disclose about you to someone who is involved in your care or the payment for your care. If you ask me to disclose information to another party, you may request that I limit the information I disclose. However, I am not required to agree to a restriction you request and I may say “no” if I believe it would affect your health care. To request restrictions, you must make your request in writing, and tell me: 1) what information you want to limit; 2) whether you want to limit my use, disclosure or both; and 3) to whom you want the limits to apply.

  • The Right to Choose How I Send PHI to You: You have the right to ask me to contact you in a specific way (for example, home or office phone) or to send mail to a different address. (For example, you may not want a family member to know that you are seeing me. Upon your request, I will send your bills to another address. You may also request that I contact you only at work, or that I do not leave voice mail messages.) To request alternative communication, you must make your request in writing, specifying how and/or where you wish to be contacted.

  • The Right to See and Get Copies of Your PHI: Other than “psychotherapy notes,” you have the right to get an electronic or paper copy of your medical record and other information that I have about you. I will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request, and I may charge a reasonable, cost-based fee for doing so. I may deny your request to inspect and copy in some circumstances and refuse information compiled in reasonable anticipation of, or use in, a civil criminal, or administrative proceeding. 

  • The Right to Get a List of the Disclosures I Have Made: You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided me with an Authorization. I will respond to a written request for an accounting of disclosures within 60 days of receiving your request.

  • The Right to Correct or Update Your PHI: If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that I correct the existing information or add the missing information. In addition, you must provide a reason that supports your request. I may deny your request if you ask me to amend information that: 1) was not created by me; 2) is not part of the medical information kept by me; 3) is not part of the information which you would be permitted to inspect and copy; 4) is accurate and complete. If I decline your request, I will tell you why in writing within 60 days of receiving your request. 

  • Disclosures to family, friends, or others: I may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.

  • Right to a copy of this notice: You have the right to an electronic and/or paper copy of this notice at any time.

IV. UPDATES TO THIS POLICY

I may update this Privacy Policy from time to time and such changes will apply to all information I have about you. Any changes will be posted on this page with the updated revision date. Your continued engagement in therapy services and/or use of the website after changes are posted constitutes your acceptance of the updated policy. Any new Privacy Policies will be available upon request, in my office, and on my website.

V. COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint. To do this, you must submit your request in writing to my office. You may also send a written complaint to the U.S. Department of Health and Human Services.