Effective Date: November 14, 2024

This Notice from TherapyDave^™ describes how your medical information may be used and disclosed, and how you can access this information. Please review it carefully.

Your Rights

When it comes to your information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your health records

You can ask to see or get an electronic or paper copy of your medical record and other information we have about you. We will provide a copy or summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your health records

You can ask us to correct health information about you that you think is incorrect or incomplete. We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications

You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.

Get a list of those with whom we’ve shared information

You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

File a complaint if you feel your rights are violated

You can complain if you feel we have violated your rights by contacting us at 2440 Willamette Street, Suite 101-C, Eugene, Oregon, 97405-3170. You can also 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, visiting HHS Complaints at https://www.hhs.gov/ocr/privacy/hipaa/complaints/ or calling 1-877-696-6775. We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, let us know.

In these cases, you have both the right and choice to tell us to:

Share information with your family, close friends, or others involved in your care
Share information in a disaster relief situation

If you are unable to tell us your preference, for example, if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases, we never share your information unless you give us written permission:

Marketing purposes
Sale of your information
Most sharing of psychotherapy notes

In Oregon, psychotherapy notes require a higher level of consent. These notes cannot be shared without your specific written consent, even for treatment purposes.

Our Uses and Disclosures

We typically use or share your health information in the following ways:

Treat you

We can use your health information and share it with other professionals who are treating you. Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization

We can use and share your information to run our practice, improve your care, and contact you when necessary. Example: We use health information about you to manage your treatment and services.

Bill for your services

We can use and share your information to bill and get payment from health plans or other entities. Example: We give information about you to your health insurance plan so it will pay for your services.

Appointment reminders

We may send you email and/or text messages for appointment reminders. You can opt-out of this service at any time. Example: You receive an email reminding you about your upcoming appointment.

How Else Can We Use or Share Your Health Information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and to comply with the law. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: HIPAA Guidance at https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/

Help with public health and safety issues

We can share information about you for certain situations such as:

Preventing disease
Reporting suspected abuse, neglect, or domestic violence
Preventing or reducing a serious threat to anyone’s health or safety
Health research

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services to ensure we are complying with federal privacy law.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests

We can use or share health information about you for the following purposes:

For workers’ compensation claims
For law enforcement purposes or with a law enforcement official
With health oversight agencies for activities authorized by law
For special government functions such as military, national security, and presidential protective services.

Respond to lawsuits and legal actions

We can share information about you in response to a court or administrative order, or in response to a subpoena.

Other Uses and Disclosures

Other uses and disclosures of your health information not covered by this notice or the laws that apply to us will only be made with your written authorization. If you provide us with permission to use or share your information, you may revoke that permission at any time.

Our Responsibilities

We are required by law to maintain the privacy and security of your protected health information.
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in this notice and give you a copy of it.
We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see the HHS’s Health Information Privacy Page at https://www.hhs.gov/hipaa/for-individuals/notice-privacy-practices/

Changes to the Terms of This Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website at https://therapydave.com/notice-of-privacy-practices/

Contact Information

If you have any questions about this notice or if you want to request additional information, please contact us at:

Dave Lechnyr, LCSW
2440 Willamette St #101-C
Eugene, OR 97405
1-541-705-4666