Notice of Privacy Practices
Effective date: November 14, 2026
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, Katie Schloss, AM, LCSW, am required by law to maintain the privacy of your protected health information ("PHI"), to give you this notice of my legal duties and privacy practices, to follow the terms of the notice currently in effect, and to notify you if a breach of your unsecured PHI occurs. PHI is information that identifies you and relates to your past, present, or future physical or mental health, the care you receive, or payment for that care.
When the laws of the state where you receive services (Connecticut, Florida, Illinois, New York, or Virginia) give your information greater protection than federal law, I follow the stricter law.
How I may use and disclose your information without your written authorization
Treatment. I may use and disclose PHI to provide and coordinate your care, for example consulting with another treating provider, generally with your knowledge.
Payment. I may use and disclose PHI to bill and collect payment for services, such as preparing a superbill you can submit to your insurance company.
Health care operations. I may use and disclose PHI to run my practice, such as for quality review, clinical consultation, record-keeping, and working with business associates (for example, secure electronic health record, telehealth, scheduling, and billing services) who are contractually required to protect your information.
Appointment reminders. I may contact you to remind you of appointments or to share information about your care.
Other uses and disclosures permitted or required by law
In limited circumstances, and only as permitted or required by federal and state law, I may use or disclose PHI without your authorization:
When required by law;
To prevent or lessen a serious and imminent threat to your health or safety or the safety of others;
To report suspected abuse, neglect, or exploitation of a child, elderly person, or vulnerable adult to the appropriate authorities;
For health oversight activities, such as audits or investigations by a licensing board;
In response to a court order, subpoena, or other lawful process, as allowed by law;
For certain law enforcement purposes, as required by law;
To coroners or medical examiners, as allowed by law;
For specialized government functions, such as national security, as required by law;
To comply with workers' compensation laws;
For public health activities, as required by law.
Uses and disclosures that require your written authorization
Other than as described above, I will not use or disclose your PHI without your written authorization. In particular, your written authorization is required for most uses and disclosures of psychotherapy notes, for marketing purposes, and for any sale of PHI. I do not sell PHI or use it for marketing. You may revoke an authorization in writing at any time, except to the extent I have already acted on it.
Your rights
Right to inspect and copy. You may ask to see or get an electronic or paper copy of your records. I will respond within the time required by law and may charge a reasonable, cost-based fee. In limited circumstances, I may deny access, and you may request a review of that decision.
Right to request an amendment. You may ask me to correct information you believe is incorrect or incomplete. I may deny the request in writing and explain why.
Right to an accounting of disclosures. You may request a list of certain disclosures I have made of your PHI in the six years before your request.
Right to request restrictions. You may ask me to limit how I use or share your PHI. I am not required to agree, except that if you pay for a service out of pocket in full, you may ask me not to share information about that service with your health insurer, and I will agree unless the law requires the disclosure.
Right to confidential communications. You may ask me to contact you in a specific way (for example, only by email or at a particular phone number). I will accommodate reasonable requests.
Right to choose someone to act for you. If someone is your legal representative, that person can exercise your rights and make choices about your PHI.
Right to 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.
Right to be notified of a breach. You will be notified if a breach occurs that may have compromised the privacy or security of your PHI.
Changes to this notice
I may change the terms of this notice, and the changes will apply to all information I hold about you. The current notice will always be available on this website and on request.
Questions and complaints
If you have questions about this notice or want to exercise any of your rights, please contact me. If you believe your privacy rights have been violated, you may file a complaint with me or with the U.S. Department of Health and Human Services Office for Civil Rights by mail at 200 Independence Avenue, S.W., Washington, D.C. 20201, by phone at 1-877-696-6775, or online at hhs.gov/ocr/complaints. I will not retaliate against you for filing a complaint.
Contact
Katie Schloss, AM, LCSW (Privacy Officer)
Email: ks@katieschloss.com
Phone: (312) 420-2393