Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Citrine Counseling is required by law to maintain the privacy and security of your protected health information. We are required to give you this notice explaining our legal duties and privacy practices with respect to your health information. We are required to follow the terms of the notice currently in effect.
Your Rights
You have the right to:
Get an electronic or paper copy of your medical record
Ask us to correct your medical record
Request confidential communications
Ask us to limit what we use or share
Get a list of certain disclosures of your information
Get a copy of this privacy notice
Choose someone to act for you
File a complaint if you believe your privacy rights have been violated
Get a Copy of Your Medical Record
You may ask to see or receive an electronic or paper copy of your medical record and other health information we have about you. We will provide a copy or summary of your health information, usually within 30 days of your request, unless a different timeframe applies under law.
We may charge a reasonable, cost-based fee.
Ask Us to Correct Your Medical Record
You may ask us to correct health information about you that you believe is incorrect or incomplete.
We may deny your request in some circumstances, but we will explain the reason in writing.
Request Confidential Communications
You may ask us to contact you in a specific way, such as by phone, email, client portal, or mail.
We will accommodate reasonable requests when possible.
Ask Us to Limit What We Use or Share
You may ask us not to use or share certain health information for treatment, payment, or health care operations.
We are not always required to agree to your request, but we will consider it carefully.
If you pay for a service out of pocket in full, you may ask us not to share information about that service with your health insurer for payment or health care operations.
Get a List of Disclosures
You may ask for a list of certain times we have shared your health information.
This list will not include every disclosure, such as disclosures for treatment, payment, health care operations, or disclosures you authorized.
Get a Copy of This Notice
You may ask for a paper copy of this notice at any time, even if you agreed to receive it electronically.
Choose Someone to Act for You
If you have given someone medical power of attorney, legal authority, or if someone is your legal guardian, that person may be able to exercise your rights and make choices about your health information.
We may verify that the person has authority before taking action.
File a Complaint
You may file a complaint if you believe your privacy rights have been violated.
You may contact Citrine Counseling directly using the contact information listed on this website.
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.
We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you may tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, let us know.
You may tell us whether to:
Share information with family, close friends, or others involved in your care
Share information in a disaster relief situation
Contact you for appointment reminders or service-related communications
If you are not able to tell us your preference, we may share information if we believe it is in your best interest or if needed to lessen a serious and imminent threat to health or safety.
We will not use or disclose your health information for marketing purposes, sale of your information, or most sharing of psychotherapy notes without your written authorization, unless permitted or required by law.
You may revoke an authorization in writing at any time, except to the extent we have already relied on it.
How We May Use and Disclose Your Information
We may use and disclose your health information in the following ways.
Treatment
We may use and disclose your health information to provide, coordinate, or manage your care.
Example: We may use information from your intake paperwork, therapy sessions, or treatment history to provide counseling services or coordinate care with another provider if appropriate.
Payment
We may use and disclose your health information to bill and receive payment for services.
Example: We may use your information to process payment, provide invoices, superbills, receipts, or respond to payment-related questions.
Health Care Operations
We may use and disclose your health information to operate the practice and improve care.
Example: We may use information for scheduling, documentation, quality improvement, consultation, legal compliance, professional supervision, business management, or secure practice management systems.
Business Associates
We may share information with vendors or service providers who help us operate the practice, such as secure practice management, billing, payment processing, website, communications, or technology providers.
When required, these vendors must agree to protect your information.
Required or Permitted by Law
We may use or disclose your health information when required or permitted by law.
Examples include:
Reporting suspected abuse or neglect
Responding to court orders or legal process
Cooperating with health oversight activities
Reporting certain threats to health or safety
Complying with workers’ compensation or other applicable laws
Responding to law enforcement requests when legally required or permitted
Serious Threat to Health or Safety
We may use or disclose your health information if necessary to prevent or lessen a serious and imminent threat to your health or safety or the health or safety of another person.
Public Health and Safety
We may disclose health information for certain public health and safety purposes when required or permitted by law.
Legal Proceedings
We may disclose information in response to a court or administrative order, subpoena, discovery request, or other lawful process, but only as permitted by applicable law.
Psychotherapy Notes
Psychotherapy notes receive special protection under HIPAA. We generally must obtain your written authorization before using or disclosing psychotherapy notes, except in limited circumstances permitted by law, such as use by your therapist for treatment, certain training purposes, legal defense, health oversight, coroner or medical examiner activities, or to prevent or lessen a serious and imminent threat.
Substance Use Disorder Information
Certain substance use disorder treatment records may receive additional protections under federal law, including 42 CFR Part 2, when applicable.
If Citrine Counseling creates or receives records protected by Part 2, those records may be subject to additional restrictions on use, disclosure, redisclosure, and consent. We will handle such information in accordance with applicable federal and state law.
HHS updated model privacy notices in 2026 to include substance use disorder patient-record information where applicable, with covered entities required to include this information as of February 16, 2026.
Our Responsibilities
Citrine Counseling is required to:
Maintain the privacy and security of your protected health information
Follow the duties and privacy practices described in this notice
Notify you if a breach occurs that may have compromised the privacy or security of your information
Provide you with a copy of this notice
Not use or share your information other than as described here unless you authorize us in writing
Changes to This Notice
We may change this notice from time to time. Changes may apply to information we already have about you as well as new information.
The current notice will be posted on our website and will include the effective date.
Effective date: May 28, 2026