Notice of Privacy Practices

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

I am required by law to maintain the privacy and security of your protected health information (“PHI”) and to provide you with this Notice of Privacy Practices (“Notice”). I must follow the terms of this Notice and will notify you if a breach of your unsecured PHI occurs. I may change the terms of this Notice, and any changes will apply to all PHI I have about you. A copy of the revised Notice will be available upon request, in my office, and on my website.

Except for the specific purposes described below, I will use and disclose your PHI only with your written authorization (“Authorization”). You may revoke an Authorization at any time in writing.

Uses and Disclosures That Do Not Require Your Authorization: I may use or disclose your PHI without your written permission for the purposes of treatment, payment, and health care operations.

  • Treatment: I may use or disclose your PHI to coordinate your care with other health professionals. For example, if you are receiving services from a physician or psychiatrist, I may share PHI to support your treatment, although I prefer to obtain your written authorization first.

  • Payment: I may use or disclose your PHI to bill and receive payment for the services I provide. This may include submitting claims to your insurance company or other third-party payers.

  • Health Care Operations: I may use or disclose your PHI as part of running my practice. This may include quality improvement efforts, legal consultations, or other administrative activities related to compliance and practice management.

Other Disclosures That Do Not Require Authorization: I may also disclose your PHI without your written consent in situations permitted or required by law, including:

  • When disclosure is required by federal or state law and limited to what the law allows.

  • For public health activities such as reporting suspected abuse or neglect, or preventing a serious threat to health or safety.

  • For oversight activities like audits, investigations, or inspections by authorized agencies.

  • In response to a court or administrative order. I prefer to obtain your authorization but may be legally required to disclose PHI.

  • To law enforcement when reporting a crime on the premises or as otherwise required by law.

  • To a coroner or medical examiner for identification or cause of death purposes.

  • For research purposes approved by an institutional review board with proper safeguards in place.

  • For specialized government functions including military, national security, or correctional situations.

  • To comply with workers’ compensation laws.

  • To provide appointment reminders or inform you about treatment alternatives or other health-related services.

Psychotherapy Notes: I do not keep “psychotherapy notes” as defined under HIPAA in 45 CFR § 164.501. I maintain a clinical record of your treatment. You may request a copy of this record or a summary of your treatment at any time. Reasonable, cost-based fees may apply for copies or summaries.

Marketing and Sale of PHI: I will not use or disclose your PHI for marketing purposes or sell your PHI in the regular course of business.

Disclosures Involving Others: I may share your PHI with a family member, friend, or someone involved in your care or payment for your care, unless you object. In emergencies, I may disclose necessary information before you have the opportunity to object, but you will be given the option afterward.

Your Rights Regarding Your PHI:

You have the right to request that I limit how I use or disclose your PHI for treatment, payment, or operations. While I will consider your request, I am not required to agree. You have the right to request restrictions on disclosures to health plans if the PHI relates solely to services you paid for in full out-of-pocket.

You may request that I communicate with you in a specific way (for example, only by phone or only at a specific address), and I will honor all reasonable requests.

You have the right to access and receive a paper or electronic copy of your clinical record, excluding psychotherapy notes (which I do not maintain). I will respond within 30 days of your written request. A reasonable, cost-based fee may be charged.

You have the right to request an accounting of certain disclosures made in the past six years (excluding those related to treatment, payment, or operations). One request per year is free; additional requests may incur a reasonable fee.

If you believe your PHI is inaccurate or incomplete, you have the right to request an amendment. I will review your request and respond within 60 days. If I deny your request, I will provide a written explanation.

You may request a paper or electronic copy of this Notice at any time, even if you previously received it electronically.

How to File a Complaint:

If you believe your privacy rights have been violated, you may file a complaint with me at:

Insight Counseling Center
Attn: Sheila Paul, LMFT
15437 Anacapa Rd
Victorville, CA 92392
Phone: (760) 912-2514

You may also file a complaint with the U.S. Department of Health and Human Services:

There will be no retaliation for filing a complaint.

This notice first became effective on September 20, 2017 and was updated May 17, 2025.