Notice of Privacy Policies

We respect your privacy and take confidentiality seriously. This notice explains how your information may be used and your rights.

EFFECTIVE DATE OF THIS NOTICE 4/15/26

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

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 with care, transparency, and respect. I create a record of the care and services you receive from me. This record allows me to provide you with high-quality care and to comply with applicable legal and ethical requirements.

This Notice applies to all records of your care generated by this mental health care practice. It explains:

  • How I may use and disclose your health information

  • Your rights with respect to the health information I keep about you

  • My legal duties regarding the use and disclosure of your health information

I am required by law to:

  • Maintain the privacy of your Protected Health Information (“PHI”)

  • Provide you with this Notice describing my legal duties and privacy practices

  • Abide by the terms of the Notice currently in effect

I reserve the right to change the terms of this Notice. Any changes will apply to all PHI I maintain. An updated Notice will be available upon request, in my office, and on my website.

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

The following categories describe different ways that I may use and disclose health information. Not every use or disclosure in a category will be listed; however, all permitted uses and disclosures will fall within one of these categories.

A. For Treatment, Payment, and Health Care Operations

Federal privacy regulations allow health care providers who have a direct treatment relationship with a patient to use or disclose PHI without written authorization for treatment, payment, or health care operations.

Examples include:

  • Consulting with another licensed health care provider about your condition

  • Coordinating care or making referrals

  • Billing and administrative activities necessary to operate the practice

Disclosures for treatment purposes are not limited to the minimum necessary standard, as health care providers may need access to the full record to provide quality care.

B. Lawsuits and Disputes

If you are involved in a lawsuit or legal proceeding, I may disclose health information in response to a court or administrative order. I may also disclose health information in response to a subpoena, discovery request, or other lawful process, but only if efforts have been made to notify you of the request or to obtain an order protecting the requested information.

III. HEIGHTENED PROTECTIONS FOR SENSITIVE HEALTH INFORMATION

Certain categories of health information are subject to enhanced privacy protections under federal law. My practice is committed to honoring these protections and minimizing disclosures whenever possible.

A. Substance Use Disorder Records (42 CFR Part 2)

To the extent that this practice maintains records related to substance use disorder diagnosis, treatment, or referral that are subject to 42 CFR Part 2:

  • Such records will not be used or disclosed for investigations or legal proceedings against you without:

    • Your specific, written consent, or

    • A court order and subpoena that expressly authorize the disclosure

These protections apply even when other laws might otherwise permit disclosure of health information.

B. Reproductive Health Information

This practice is committed to protecting your privacy with respect to reproductive health information, consistent with recent federal privacy regulations.

  • Your PHI will not be used or disclosed to identify, investigate, or prosecute any person for seeking, obtaining, providing, or facilitating lawful reproductive health care.

Reproductive health care includes, but is not limited to:

  • Contraception

  • Preconception counseling

  • Infertility evaluation and treatment

  • Pregnancy-related care, including abortion

  • Care for reproductive system conditions

Such PHI will be disclosed only if:

  • You provide signed, written authorization;

  • Disclosure is required by federal law; or

  • A signed and valid attestation is received confirming the request is not for a prohibited investigation or prosecution.

IV. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION

Psychotherapy Notes

I maintain psychotherapy notes as defined by federal law. Any use or disclosure of psychotherapy notes requires your written authorization, except in the following circumstances:

  • For my use in treating you

  • For training or supervision of mental health practitioners

  • For my defense in legal proceedings initiated by you

  • For investigation of my compliance with HIPAA by the Secretary of Health and Human Services

  • When required by law and limited to the requirements of that law

  • For certain health oversight activities related to the originator of the notes

  • For a coroner performing legally authorized duties

  • To help avert a serious threat to health or safety

Marketing and Sale of PHI

  • I will not use or disclose your PHI for marketing purposes

  • I will not sell your PHI in the regular course of business

V. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION

Subject to legal limitations, I may use or disclose your PHI without authorization:

  • When required by state or federal law

  • For public health activities (e.g., reporting suspected child, elder, or dependent adult abuse)

  • For health oversight activities such as audits or investigations

  • For judicial or administrative proceedings, typically in response to a court order

  • For law enforcement purposes related to crimes occurring on my premises

  • To coroners or medical examiners performing legally authorized duties

  • For approved research purposes

  • For specialized government functions (e.g., military, national security, correctional institutions)

  • For workers’ compensation claims, as required by law

  • To provide appointment reminders or information about treatment alternatives or health-related services

VI. USES AND DISCLOSURES REQUIRING OPPORTUNITY TO OBJECT

I may disclose your PHI to family members, friends, or others involved in your care or payment for care unless you object. In emergencies, consent may be obtained retroactively.

VII. YOUR RIGHTS REGARDING YOUR PHI

You have the right to:

  • Request limits on how your PHI is used or disclosed (approval not guaranteed)

  • Request restrictions on disclosures to health plans for services paid out-of-pocket in full

  • Request confidential communications (e.g., specific phone number or address)

  • Inspect and obtain copies of your PHI (excluding psychotherapy notes)

  • Request an accounting of disclosures made in the past six years

  • Request corrections or amendments to your PHI

  • Receive a paper or electronic copy of this Notice at any time

Questions or Complaints

If you have questions about this Notice or believe your privacy rights have been violated, you may contact our Privacy Officer/Founder at jen@pmhcchicago.com or by phone at 312-487-1771. You may also file a complaint with the U.S. Department of Health and Human Services. We will not retaliate against you for filing a complaint.