Notice of Privacy Practices

Effective Date: July 1, 2026

This Notice of Privacy Practices describes how health information about you may be used and disclosed and how you can access this information. Please review it carefully.

This notice applies to services provided by Jacqueline Anderson, LPC, PLLC.

My commitment to your privacy

Your privacy matters. I am required by law to protect the privacy of your health information and to provide you with this notice explaining my legal duties and privacy practices.

When you begin therapy, I may collect information about your health history, current concerns, treatment goals, diagnosis, treatment, payment, and other information related to your care. This information is called protected health information, or PHI.

I will only use or disclose your information as permitted or required by law.

How I may use and disclose your health information

Treatment

I may use your health information to provide therapy and coordinate your care. This may include documenting sessions, developing a treatment plan, consulting with other professionals when appropriate, or communicating with other providers involved in your care if you have authorized that communication or if it is otherwise permitted by law.

Payment

I may use and disclose your health information for payment-related purposes. This may include charging your credit card, providing receipts, creating superbills, or communicating with you about payment.

If you choose to submit superbills to your insurance company, the superbill may include information such as your name, diagnosis, dates of service, service codes, and fees.

Health care operations

I may use and disclose your health information for practice operations. This may include scheduling, quality improvement, consultation, legal compliance, billing, recordkeeping, and other activities necessary to operate the practice.

Uses and disclosures that may occur without your written authorization

There are some situations where I may be permitted or required by law to use or disclose your health information without your written authorization. These may include:

  • When disclosure is required by federal, state, or local law

  • To prevent or reduce a serious and imminent threat to your health or safety, or the health or safety of another person

  • Reports of suspected child abuse or neglect

  • Reports of suspected abuse, neglect, or exploitation of vulnerable adults, when required by law

  • Certain health oversight activities, such as licensing board investigations

  • Court orders, subpoenas, or other legal proceedings when legally required

  • Workers’ compensation matters, when applicable

  • Medical emergencies

  • Public health activities, when required by law

Psychotherapy notes

Psychotherapy notes receive special protection under federal law. These are notes recorded by a mental health professional documenting or analyzing the contents of a counseling session and kept separate from the medical record.

I will not use or disclose psychotherapy notes without your written authorization except in limited circumstances permitted by law, such as for my own use in treatment, certain training or supervision purposes, defense in a legal action or other proceeding brought by you, health oversight activities required by law, or when necessary to prevent or reduce a serious and imminent threat.

Uses and disclosures that require your written authorization

I will ask for your written authorization before using or disclosing your health information for purposes not otherwise allowed by law.

Written authorization is generally required for:

  • Most disclosures of psychotherapy notes

  • Marketing communications involving protected health information, unless an exception applies

  • Sale of protected health information

  • Sharing information with family members, partners, friends, schools, attorneys, or other providers, unless otherwise permitted or required by law

You may revoke an authorization in writing at any time. Revoking an authorization will not affect information already disclosed based on your prior authorization.

Communication by email, phone, text, and portal

I may communicate with you by phone, voicemail, email, text, or secure client portal depending on the nature of the communication and your preferences.

Email, voicemail, and text messaging may not be fully secure. I use reasonable safeguards, but I cannot guarantee the privacy of information sent through unsecured communication methods.

Please do not use email, voicemail, text, or website forms for emergencies or crisis situations.

Website contact form

The website contact form is for general inquiries only. Please do not include detailed personal, medical, or clinical information in the website contact form.

If you become a client, intake paperwork and clinical communication will take place through a secure client portal whenever appropriate.

Your rights

You have the right to:

Request access to your records

You may request to inspect or receive a copy of your health records. Some limited exceptions may apply.

Request an amendment

You may ask me to amend your health record if you believe it is incorrect or incomplete. I may deny the request in certain circumstances, but I will explain the reason in writing.

Request restrictions

You may ask me to limit how I use or disclose your health information. I am not required to agree to every requested restriction, except in certain situations required by law.

Request confidential communications

You may ask me to contact you in a specific way or at a specific location. I will accommodate reasonable requests.

Receive an accounting of disclosures

You may request a list of certain disclosures of your health information.

Receive a paper copy of this notice

You may request a paper copy of this notice at any time.

Be notified following a breach

You have the right to be notified if there is a breach of unsecured protected health information that affects you.

Changes to this notice

I may change this Notice of Privacy Practices at any time. Any revised notice will apply to information already in my possession as well as information created or received in the future.

The current version will be posted on my website.

Questions or complaints

If you have questions about this notice or believe your privacy rights have been violated, you may contact:

Privacy Contact: Jacqueline Anderson, LPC
Practice: Jacqueline Anderson, LPC, PLLC
Email: jacqueline@jacquelineandersonlpc.com

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.

You will not be retaliated against for filing a complaint.