Notice of Privacy Practices

1. Uses and Disclosures of Your Health Information

As a psychological practice, we create and maintain records of your treatment and services. This protected health information (“PHI”) may be used and disclosed for:

Treatment

We use your PHI to provide, coordinate, and manage your care. For example, your psychologist may share information with our office staff, other clinicians involved in your care, or external providers you are referred to.

Payment

We may use and disclose PHI to bill and collect payment for services. This may include billing your insurance company, health plan, or other third-party payer.

Healthcare Operations

We may use and disclose your PHI for activities such as quality improvement, staff training, compliance audits, and general administrative functions.

2. Uses and Disclosures Requiring Your Authorization

Uses and disclosures not covered by this notice or applicable law require your written authorization, including:

• Most uses and disclosures of psychotherapy notes (where separately maintained)
• Marketing purposes
• Sale of your PHI
• Disclosures that constitute a sale of information

You may revoke an authorization at any time in writing.

3. Uses and Disclosures We May Make Without Your Authorization

We may disclose your PHI without your authorization in the following circumstances:

• As required by law — for court orders, warrants, or similar legal processes
• Public health activities — reporting abuse, neglect, or domestic violence (where permitted)
• Health oversight activities — audits, investigations, or inspections by government agencies
• Judicial and administrative proceedings — in response to subpoenas or court orders in family law, criminal, or civil matters
• Law enforcement — in response to valid law enforcement requests
• To avert a serious threat — to prevent a serious threat to the health or safety of a person or the public
• Coroners, medical examiners, funeral directors — as necessary to carry out their duties
• Research — only when an institutional review board (IRB) has approved the research with appropriate safeguards
• Workers' compensation — as authorized by law

4. Patient Access to Records

You have the right to access, inspect, and obtain a copy of your PHI in our designated record set for as long as we maintain it. Requests must be made in writing. We will respond within 30 days. We may deny your request in certain limited circumstances (e.g., if a licensed healthcare professional determines that access could endanger your life or another person).

To request access or amendments to your records, contact our office at (801) 483-1600 or in writing at cps@wecanhelpout.com.

5. Amendments to Your Records

You may request that we amend your PHI if you believe it is inaccurate or incomplete. Requests must be in writing and explain why you believe the information should be amended. We may deny your request if, for example, the information was not created by us or we determine it is accurate and complete.

6. Accounting of Disclosures

You have the right to receive an accounting of certain disclosures we have made of your PHI. This accounting does not include disclosures made for treatment, payment, or healthcare operations, or disclosures made before April 14, 2023. Requests must be made in writing. We will provide the accounting within 60 days (with a possible 30-day extension).

7. Right to Request Restrictions

You have the right to request restrictions on certain uses and disclosures of your PHI. We are not required to agree to a restriction unless the disclosure is to a health plan for the purpose of carrying out payment or healthcare operations and the PHI pertains solely to a service for which you have paid in full out of pocket.

8. Right to Confidential Communications

You have the right to request that we communicate with you in a certain way (e.g., only by phone, or at a specific address). We will accommodate reasonable requests.

9. Paper Copy of This Notice

You have the right to receive a paper copy of this Notice of Privacy Practices at any time, even if you have agreed to receive it electronically.

10. Changes to This Notice

We reserve the right to change this notice and make the new provisions effective for all PHI we maintain. The updated notice will be posted on our website and available at our office.

11. Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer at cps@wecanhelpout.com or (801) 483-1600. You may also file a complaint with:

Note: There will be no retaliation against any individual for filing a complaint.

12. Privacy Officer Contact