Notice of Privacy Practices

Your Rights

You have the right to receive a copy of your health records, request corrections to your records, receive a list of disclosures, request restrictions on how your information is used, and receive a copy of this notice.

You may request a copy of your records at any time by contacting Kozi Korner through the SimplePractice client portal.

How We Use Your Information

Kozi Korner uses your health information for treatment (providing therapy services), payment (processing session fees), and healthcare operations (quality improvement, training, and practice administration).

We may also use or disclose your information when required by law, for public health activities, to prevent serious threats to health or safety, and for other purposes permitted or required by HIPAA.

Disclosures Without Your Authorization

We may disclose your health information without your written authorization in the following circumstances:

• When required by law
• When there is a serious and imminent threat to your safety or the safety of others
• When there is suspected abuse, neglect, or domestic violence
• For public health activities
• For oversight activities authorized by law (e.g., audits, investigations)
• In response to a court order or subpoena

Your Choices

You have the right to tell us your preferences about how we share your information. You may request restrictions on how we use or disclose your information, though we are not required to agree to all requests.

You may also request that we communicate with you in a specific way or at a specific location.

Our Responsibilities

Kozi Korner is 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.

Changes to 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.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with Kozi Korner or with the U.S. Department of Health and Human Services Office for Civil Rights.

To file a complaint with us, contact: [email protected]

To file a complaint with HHS: www.hhs.gov/hipaa/filing-a-complaint

We will not retaliate against you for filing a complaint.

Contact Information

For questions about this notice, contact Kozi Korner at [email protected]. Clinical communication should be directed through the SimplePractice client portal.