NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW INFORMATION MAY BE USED AND DISCLOSED. PLEASE REVIEW IT CAREFULLY.
I. MY PLEDGE REGARDING YOUR INFORMATION:
I understand that personal information about you and your life is personal. I am committed to protecting the information received about you. I create a record of the care and services you receive from Xavier Buo. I need this record to provide you with quality care. This notice applies to all of the records of your care generated by this practice. This notice will tell you about the ways in which I may use and disclose information about you. I also describe your rights to the information I keep about you, and describe certain obligations I have regarding the use and disclosure of your information.
Lawsuits and Disputes: If you are involved in a lawsuit, I may disclose information in response to a court or administrative order. I may also disclose information about your child in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
II. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:
1. Notes. I do keep “client notes” and any use or disclosure of such notes requires your Authorization unless the use or disclosure is: a. For my use in supporting you. b. For my use in training or supervising practitioners to help them improve their skills in group, joint, family, or individual counseling or coaching. c. For my use in defending myself in legal proceedings instituted by you. d. Required to help avert a serious threat to the health and safety of others.
2. Marketing Purposes. I will not use or disclose your information for marketing purposes without your consent. You are not obligated to agree to any request for testimonials or marketing purposes.
III. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT.
Disclosures to family, friends, or others. I may provide your information to a family member, friend, or other person that you indicate is involved in your service or the payment for your service, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.
EFFECTIVE DATE OF THIS NOTICE
This notice went into effect on May 20, 2020.