Notice of Privacy Practices
Who this notice covers
This notice applies to the practice of Marianne Carlson, PsyD, Licensed Psychologist (Texas License #38750), located at 2828 Buffalo Terrace, Houston, TX 77019, and to all protected health information created or maintained by the practice.
How your information may be used and disclosed
Without your written authorization
Certain uses and disclosures are permitted or required by law and do not need your authorization. These include treatment, obtaining payment for services, and routine health care operations, as well as the specific circumstances listed under limits to confidentiality below.
With your written authorization
Most other uses and disclosures require your written authorization, which you may revoke at any time in writing. Psychotherapy notes, any use of your information for marketing, and any sale of your information all require your specific authorization.
Limits to confidentiality
As described at your first session, disclosure may be required or permitted without your authorization in a limited set of circumstances:
- When there is a serious and imminent risk of harm to you or to another identifiable person
- When there is reasonable cause to believe a child, elderly person, or person with a disability is being abused or neglected
- In response to a valid court order or other legal requirement
- For health oversight activities conducted by a licensing board or similar authority
These are reviewed with you in detail at the first session so there are no surprises.
Your rights regarding your information
- To inspect and receive a copy of your record, subject to limited exceptions
- To request that your record be amended if you believe it is incorrect or incomplete
- To receive an accounting of certain disclosures of your information
- To request restrictions on how your information is used or disclosed
- To request that communications reach you by a particular method or at a particular address
- To receive a paper copy of this notice on request
- To be notified if a breach of your unsecured protected health information occurs
Telehealth and electronic communication
Video sessions are conducted over a secure, HIPAA-compliant platform. Email and web forms are not fully secure, which is why you are asked not to include detailed clinical or personal information in an initial message. Sensitive matters are better covered by phone or in session.
Practice responsibilities
The practice is required by law to maintain the privacy of your protected health information, to provide you with this notice of its legal duties and privacy practices, and to notify you following a breach of unsecured protected health information. The terms of this notice will be followed until it is changed. The practice reserves the right to change this notice and to make the revised notice effective for information it already holds. A current copy is always available on this page and on request.
Questions and complaints
If you have questions about this notice, or if you believe your privacy rights have been violated, you may contact the practice at marianne@drmariannecarlson.com.
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, or with the Texas Behavioral Health Executive Council, which licenses psychologists in Texas. You will not be retaliated against for filing a complaint.
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