Privacy & HIPAA Notice

Notice of Privacy Practices

Effective date: [date]  |  Practice: Blue Cicada Somatic Sex Therapy  |  Denver, CO

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.

My commitment to your privacy

I am required by law to protect the privacy of your protected health information (PHI), to provide you with this notice of my legal duties and privacy practices, and to follow the terms of the notice currently in effect. Your PHI includes information about your health, treatment, and payment for care that could identify you.

How I may use and disclose your information

Treatment. I may use your information to provide and coordinate your care, including consultation with my clinical supervisor and, with your consent, other providers involved in your care.

Payment. I may use your information to bill and collect payment for services, including creating superbills or coordinating with Mentaya for out-of-network reimbursement, when you request it.

Health care operations. I may use your information for necessary practice operations such as quality review, supervision, and consultation.

Supervision. As a Licensed Professional Counselor Candidate (LPCC-C), I practice under clinical supervision. Your information may be discussed with my supervisor, [supervisor name, credentials, license #], who is also bound to protect your privacy.

Disclosures that may be required or permitted without your authorization

In limited situations, the law may require or permit disclosure without your written authorization, including: when there is a serious and imminent threat to your health or safety or that of another person; suspected abuse or neglect of a child, older adult, or at-risk individual; a valid court order; or other uses required by law. Colorado-specific mandatory reporting and duty-to-warn provisions apply.

Uses that require your written authorization

Most uses and disclosures of psychotherapy notes, uses for marketing, and any sale of your information require your written authorization. You may revoke an authorization in writing at any time, except to the extent I have already acted in reliance on it.

Your rights regarding your health information

You have the right to: inspect and request a copy of your records; request corrections; request confidential communications (for example, contacting you only by a certain method); request restrictions on certain uses and disclosures; receive an accounting of certain disclosures; and receive a paper copy of this notice. To exercise any of these rights, contact me at [practice email / phone].

Changes to this notice

I reserve the right to change this notice and to make the revised notice effective for information I already have as well as information I receive in the future. The current notice will always be posted here.

Complaints

If you believe your privacy rights have been violated, you may contact me at [practice contact], or file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be penalized or retaliated against for filing a complaint.

Website Privacy Statement

The contact form on this website is not encrypted. Please do not share sensitive personal or health information through it. Use it only to request a consultation; we'll move to a secure, HIPAA-compliant system for anything clinical.

When you submit the contact form, the information you provide (such as your name, email, phone, and message) is sent to me by email so I can respond to your inquiry. It is not sold or shared with third parties for marketing.

This site may use basic, privacy-respecting analytics to understand general traffic patterns. It does not use tracking that identifies you personally. This website is not a substitute for professional care and does not create a therapist–client relationship.

In an emergency, call 911 or go to your nearest emergency room. You can also call or text the 988 Suicide & Crisis Lifeline.