Strengthening marriages, one at a time.

Protecting your privacy is very important to us. This notice describes how we collect, use and disclose your protected health information to carry out treatment, payment, or healthcare options and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. Please review it carefully. This notice took effect 4/14/2003 and remains in effect unless we replace it. 

COLLECTION OF INFORMATION

• We may collect nonpublic information from the following sources:
• Information we receive from you on your initial and follow-up visits, such as your name, address, phone number, date of birth, current and past health history, social security number, etc.
• Information we receive from third parties such as other doctors’ reports. 

USE & DISCLOSURE OF INFORMATION

Ways we may use and disclose your information without your specific consent authorization:

• To provide you with the best possible treatment and services.
• So that the treatment and services you receive from us may be billed and payment collected from you, an insurance company, or third party.
• For health care operations to assure you receive quality care.
• We will disclose your personal information to third parties only with your signed written consent, unless compelled by a court order.
• We do not sell or rent client information. We do not share your information with persons, companies, or organizations that would use that information to contact you about their own products and services. 
• We may use your name or address for certain marketing activities of our own, such as sending you announcements of upcoming seminars and services. We may telephone you for appointment questions or reminders unless you request otherwise. 

YOUR RIGHTS ON DISCLOSURE, CHANGES & ACCESS TO YOUR INFORMATION

You have the right to:

• Inspect or obtain a copy of your client information.
• Request an amendment to your client information. This amendment may be accepted or denied. If denied, you have the right to file a statement of disagreement.
• Request a restriction of your protected health information, stating the specific restriction and to whom it applies.
• Request a list of any disclosures we have made of your information.
• Request confidential communications, that is, how and where we should send communications. 

HOW WE PROTECT YOUR INFORMATION

We are committed to our client’s privacy and strive to protect the confidentiality of your information. Access to your information is restricted to the therapists and office assistant. All employees are educated about the importance of confidentiality and client privacy. We maintain physical, electronic, and procedural safeguards to protect your privacy. We are required to abide by the terms of this Privacy Practices Notice. We may change the terms of our notice at any time. The new notice will be effective for all protected health information that we maintain at that time. You may request any revised Privacy Practices Notice by contacting us and requesting that a revised copy be sent or given to you.