Notice of Privacy Practices

Effective Date: July 7, 2026 This Notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.

Your Privacy Is Important

During the course of treatment, I create and maintain records containing Protected Health Information (PHI) about your care. This Notice explains how your Protected Health Information may be used and disclosed, your rights regarding your health information, and my legal responsibilities to protect your privacy.

Our Responsibilities

Courtney Becker Psychotherapy is required by federal and California law to: Maintain the privacy and security of your Protected Health Information (PHI). Provide you with this Notice of Privacy Practices outlining my legal duties and privacy practices. Follow the terms of the Notice currently in effect. Notify you promptly if a breach occurs that may have compromised the privacy or security of your unsecured PHI. Abide by applicable federal and California privacy laws. I reserve the right to revise this Notice as permitted by law. Any revised Notice will apply to all Protected Health Information maintained by this practice and will be available upon request, through the Client Portal, and on the practice website.

How Your Health Information May Be Used and Disclosed

Federal and state laws allow me to use and disclose your Protected Health Information (PHI) without your written authorization for the following purposes.

Treatment

I may use your PHI and share it with other healthcare professionals who are treating you or coordinating your care (for example, a consulting physician or psychiatrist).

Payment

I may use and disclose your PHI to bill and collect payment from you, your health insurance plan, or other responsible parties.

Healthcare Operations

I may use and disclose your PHI to operate my practice, improve the quality of care provided, maintain legal and regulatory compliance, and conduct necessary business operations.

Appointment Reminders and Administrative Communications

I may use your PHI to contact you regarding appointment reminders, scheduling updates, billing matters, or other administrative communications related to your care.

Uses and Disclosures That Do Not Require Authorization

Federal and California law permit or require me to disclose your PHI without your written authorization in certain situations, including: Reporting suspected child abuse or neglect. Reporting suspected elder or dependent adult abuse or neglect. Preventing or reducing a serious and imminent threat to your health or safety or the health or safety of another person. Complying with a valid court order, judicial subpoena, or other legal proceeding. Complying with workers' compensation laws. Responding to requests from coroners, medical examiners, or funeral directors as authorized by law.

Disclosures to Family Members or Others

With your verbal permission or implied consent, I may share relevant Protected Health Information with a family member, caregiver, or other individual directly involved in your care or payment for your care. If you are unavailable or an emergency exists, I will use my professional judgment to determine whether sharing limited information is in your best interest.

Uses That Require Your Written Authorization

Certain uses and disclosures of your Protected Health Information require your written authorization. These include: Most uses and disclosures of psychotherapy notes maintained separately from your general clinical record. Marketing purposes, except as otherwise permitted by law. The sale of Protected Health Information. Any other use or disclosure not described in this Notice unless otherwise permitted or required by law. You may revoke your authorization at any time by submitting your request in writing. Revocation will not affect any actions already taken in reliance on your authorization.

Your Rights Regarding Your Protected Health Information

You have the following rights regarding the health information I maintain about you.

Inspect and Copy Your Records

You have the right to inspect or receive an electronic or paper copy of your medical and billing records. Records will be provided within the timeframes required by California law. Reasonable, cost-based copying or printing fees may apply where permitted by law.

Request Restrictions

You may request restrictions on how your Protected Health Information is used or disclosed for treatment, payment, or healthcare operations. While I am not required to agree to every request, I am required to honor your request if: You have paid for a service completely out-of-pocket (private pay), and You request that information regarding that service not be disclosed to your health insurer for payment or healthcare operations.

Request Confidential Communications

You have the right to request that I communicate with you in a particular way (for example, by cell phone instead of home phone) or at a different mailing address. Reasonable requests will be accommodated.

Request Amendments

If you believe your clinical record contains incorrect or incomplete information, you may request an amendment. If I deny your request because I believe the record is accurate and complete, I will provide a written explanation in accordance with applicable law.

Accounting of Disclosures

You have the right to request an accounting of certain disclosures of your Protected Health Information made during the six years prior to your request, excluding disclosures for treatment, payment, healthcare operations, and certain other disclosures permitted by law.

Receive a Copy of This Notice

You have the right to receive a paper or electronic copy of this Notice at any time, even if you previously agreed to receive it electronically.

Questions or Complaints

If you have questions regarding this Notice or believe your privacy rights have been violated, please contact me directly. Courtney Becker, LMFT #164046

Phone: (707) 583-1593

Email: hello@courtneybeckerlmft.com

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by visiting: www.hhs.gov/ocr/privacy/hipaa/complaints/ or by writing to the appropriate regional Office for Civil Rights.

Filing a complaint will not affect the quality of care you receive, and you will not be retaliated against for filing a complaint.