Notice of Privacy Practices

This notice describes how health information about you may be used and disclosed, and how you can get access to this information. Please review it carefully.

My Promises and Responsibilities Regarding Health Information:

Health information is personal, and I am committed to protecting your information. I create a record of the services you receive, I need this record to provide you with quality care and to comply with legal requirements. This notice applies to all of the records of your care generated by this mental health care practice. This notice will tell you about the ways in which I may use and disclose health information. I also describe your rights to the health information I keep, and describe certain obligations I have regarding the use and disclosure of health information.

I am required by law to maintain the privacy and security of your protected health information (PHI). I will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. I must follow the duties and privacy practices described in this notice and give you a copy of it. I will not use or share your information other than as described in this notice without your written authorization. I can change the terms of this notice, and the changes will apply to all information I have about you. The new notice will be available upon request and accessible on the practice’s website: www.newparadigmtherapy.com

How I May Use and Disclose Health Information

The following categories and examples describe different ways that I can use or disclose health information. Not every use or disclosure within 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.

Federal privacy rules (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/client’s written authorization, to carry out the health care provider’s own treatment, payment, or health care operations.

Examples of these uses include:

Consulting with my clinical supervisor regarding diagnosis and treatment planning
Credit card transaction information being shared through third-party payment processors
Maintaining clinical records using an electronic health record

I may also disclose PHI for the treatment activities of any health care provider. 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.

Examples of these uses include:

Consulting with a psychiatrist to provide information that may be relevant for psychiatric care
Consulting with another clinician to discuss a potential referral to them for specialist services

Certain Uses and Disclosures Require Your Authorization

Other uses and disclosures of health information will be made only with your written authorization. You may revoke your authorization in writing at any time, except to the extent that I have already acted in reliance on it. An example of this use may be using information from your treatment in professional presentations or educational materials
Psychotherapy Notes. I do keep “psychotherapy notes” as that term is defined in 45 CFR § 164.501, and any use or disclosure of such notes requires your authorization unless the use or disclosure is: a. For my use in treatment. b. For my use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy. c. For my use in defending myself in legal proceedings instituted by you or your legal representative. d. For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA. e. Required by law and the use or disclosure is limited to the requirements of such law. f. Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes. g. Required by a coroner who is performing duties authorized by law. h. Required to help avert a serious threat to the health and safety of others.
I will not use or disclose your protected health information for marketing purposes.
I will not sell your protected health information in the regular course of my business.

Certain Uses and Disclosures Do not Require Your Authorization

In certain circumstances (45 CFR § 164.512), I may be permitted or required by law to disclose your health information without your written authorization. I have to meet many conditions in the law before I can share your information for these purposes.

Examples of these uses include:

Reporting suspected abuse or neglect of minors or vulnerable adults
Preventing or reducing a serious threat to anyone’s health or safety
For health oversight activities, including audits and investigations
Complying with a state or federal law requiring disclosure, including with the Department of Health and Human Services if it wants to see that I am complying with federal privacy law.
In response to a court order or other legal proceeding, including subpoenas, when disclosure is authorized or required by applicable law.
For law enforcement purposes, including as required by laws that require the reporting of certain types of wounds or other physical injuries.
To coroners or medical examiners, when such individuals are performing duties authorized by law.
For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.
For specialized government functions, including the proper execution of military missions, protective services for federal officials, national security and intelligence activities, or helping to ensure the safety of those working within or housed in correctional institutions.
For workers’ compensation purposes.

In certain circumstances, even when authorization is not required, it may be my preference to receive a written authorization from you or your legal representatives.

V. Certain Uses and Disclosures Require You to Have the Opportunity to Object

In certain circumstances, I may use or disclose protected health information, provided that you are informed in advance and have the opportunity to agree or prohibit or restrict this use or disclosure. Both my informing you in advance and your agreement or objection may be communicated orally.

For disclosures to family, friends, or others involved in your health care or payment for services, limited to information directly relevant to their involvement. For example, sending an invoice to a family member who is paying for your therapy services.

VI. Your Rights Regarding PHI

You have rights regarding your personal health information. Requests can be communicated to me directly using the contact information listed on this form; certain requests may require written documentation:

The right to request limits on uses and disclosures of your PHI. I am not required to agree to your request, and I may say “no” if I believe it would affect your health care.
The right to request restrictions for out-of-pocket expenses paid in full. You have the right to request that I do not make disclosures of your PHI to your health plan for payment or operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.
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, and I will agree to all reasonable requests.
The right to a see and receive paper or electronic copy of your medical record. Other than “psychotherapy notes,” you have the right to get an electronic or paper copy of your medical record, or a summary if you prefer, within 30 days of receiving your written request.
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 your request for an accounting of disclosures within 60 days of receiving your request. The list I will give you will include disclosures made in the last six years unless you request a shorter time. I will provide the list to you at no charge, but if you make more than one request in the same year, I will charge you a reasonable cost-based fee for each additional request.
The right to request a correction to your paper or electronic medical record. I may say “no” to your request, but I will tell you why in writing within 60 days of receiving your request.
The right to get a copy of this privacy notice. If you would like a paper copy of this notice at any time, please let me know and I will provide one promptly.
The right to choose someone to act on your behalf. If someone has authority to act as your personal representative, such as if someone has your medical power of attorney, that person can exercise your rights and make choices about your health information. I will make sure this person has authority and can act for you before I take any action.
File a complaint if you believe your privacy rights have been violated If you feel your rights have been violated, you can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting https://www.hhs.gov/hipaa/filing-a-complaint/index.html. I will not retaliate against you for filing a complaint.

For further information or to communicate requests and authorizations, please use this contact information.

Phone: (360) 218-2148,
Email: thomas@newparadigmtherapy.com

This notice went into effect on 10/24/2026

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