At Willhouse Collaborative Family Therapy, Inc., we are committed to protecting your health information (known as Protected Health Information or PHI). PHI is any information about you that relates to your health care or payment for health care.

We are required by law to:

     - Protect your PHI

     - Provide you with this Notice

     - Notify you if a breach of your PHI occurs

     - Follow the terms of this Notice

We may update this Notice at any time. The latest version will always be available at our office and on this website.

Without Your Written Authorization

     We may use and share your PHI to:

        - Provide treatment (coordinate your care with other providers)

        - Obtain payment (bill insurance or you for services)

        - Run our practice (improve care, train staff, get legal advice)

With Your Written Authorization

     We will ask for your permission before:

        - Sharing psychotherapy notes (except in limited cases)

        - Using PHI for marketing

        - Selling your PHI

     - We will not share your reproductive health information for prohibited purposes, such as investigations or legal actions against those seeking or providing care.

     - We may request a written attestation from you before sharing this type of information to ensure it is not used inappropriately.

You have the right to:

     - Request limits on how we use or share your PHI (we may not always be able to agree)

     - Limit what we share with health plans when you pay in full out-of-pocket

     - Choose how we contact you (for example, by mail, phone, or email)

     - See and get copies of your PHI (except psychotherapy notes), including:

             ~ Inspecting your records in person and taking notes

             ~ Getting copies within 15 days (we may charge a reasonable fee)

     - Request a list of disclosures we’ve made (excluding those for treatment, payment, or operations)

     - Request corrections to your records if you think something is wrong or missing

     - Request a paper or electronic copy of this Notice

     - Psychotherapy notes are kept separate from your medical record.

     - We generally need your authorization to share these notes.

     - We may deny requests for psychotherapy notes if releasing them could cause harm.

If you believe your privacy rights have been violated, you can file a complaint with:

Dr. Monique Willis, Privacy Officer
P.O. Box 8631
Long Beach, CA 90808
Phone: 562-980-0401

Or file a complaint with the U.S. Department of Health and Human Services:

     - Mail: 200 Independence Avenue, S.W., Washington, D.C. 20201

     - Phone: 1-877-696-6775

     - Online: www.hhs.gov/ocr/privacy/hipaa/complaints

We will not retaliate against you for filing a complaint.