Psychiatric Practice Privacy Policy

Introduction

At [Practice Name], we understand the sensitive nature of mental health information and are committed to protecting your privacy. This notice describes how medical and psychological information about you may be used and disclosed and how you can access this information.

Protected Health Information (PHI)

Information We Collect

• Demographic information
• Medical and psychiatric history
• Treatment records and progress notes
• Payment and insurance information
• Communication records

Use and Disclosure of Information

Permitted Uses Without Authorization

1. Treatment: Coordinating care with other healthcare providers
2. Payment: Billing and insurance verification
3. Healthcare Operations: Quality assessment and improvement activities

Uses Requiring Authorization

• Release of psychotherapy notes
• Marketing purposes
• Sale of protected health information
• Research participation

Special Privacy Protections

Heightened Protection for Mental Health Records

• Separate written authorization for release of psychiatric records
• Additional safeguards for substance use disorder treatment information
• Special provisions for minors' mental health information

Patient Rights

• Right to inspect and copy records
• Right to request amendments
• Right to receive an accounting of disclosures
• Right to request restrictions
• Right to confidential communications

Security Measures

• Electronic health record encryption
• Staff training on privacy procedures
• Secure messaging systems
• Physical security controls

Contact Information

Privacy Officer: [Name] Phone: [Phone Number] Email: [Email Address]

Effective Date and Changes

Effective Date: [Date] Last Modified: [Date]

Acknowledgment

I acknowledge receipt of this Privacy Policy:

Patient Signature / Date