THIS NOTICE DESCRIBES HOW MEDICAL AND MENTAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
If you have any questions about this notice, please contact us at 561-301-1464 or drtinagoodin@gmail.com.
I. Our Commitment to Your Privacy
As a licensed Psychologist, I maintain the highest standards of confidentiality. Your “Protected Health Information” (PHI) includes any past, present, or future information regarding your psychological care, treatment, or billing. I am required by law to maintain the privacy of your PHI and to provide you with this notice of my legal duties and privacy practices.
II. How I May Use and Disclose Your Protected Health Information (PHI)
I may use or disclose your PHI for the following purposes without your explicit written authorization:
- For Treatment: I can use your PHI to provide, coordinate, or manage your psychological treatment. For example, I may disclose information to another clinician or physician involved in your care to coordinate a treatment plan.
- For Payment: I may use and disclose your PHI so that the services you receive can be billed and paid for. For example, I may provide clinical information to your health insurance company to confirm eligibility or obtain reimbursement.
- For Healthcare Operations: I may use your PHI to support the operational facets of my practice. This includes quality assessment reviews, internal auditing, or business planning.
III. Special Protections for Mental Health Records
- Psychotherapy Notes: Under HIPAA, the detailed notes I take during our sessions are kept separate from the rest of your medical record. These notes receive heightened protection. I will never disclose your psychotherapy notes to an insurance company, attorney, employer, or any third party without your explicit, separate written authorization, except where required by law.
- Marketing and Sale of PHI: I will never sell your PHI or use it for marketing purposes.
IV. Uses and Disclosures That Require Your Written Authorization
For any purpose not listed in Section II (such as sending records to a lawyer, a school, or a family member), I must obtain your written authorization. You may revoke this authorization at any time in writing.
V. Permitted Disclosures Without Your Consent (Mandatory Exceptions)
By law, I am required to break confidentiality and disclose your PHI without your consent in the following critical circumstances:
- Child or Elder Abuse: If I have reason to suspect the abuse, neglect, or exploitation of a child, elderly person, or disabled adult.
- Serious Threat to Health or Safety: If you present an imminent danger to yourself or to an identifiable third party.
- Court Orders: If a judge issues a lawful court order or subpoena requiring the release of your records.
VI. Your Rights Regarding Your PHI
You have the following rights regarding the mental health information I maintain about you:
- Right to Inspect and Copy: You have the right to look at or get copies of your clinical and billing records. I may deny this request in rare circumstances if I believe sharing them would cause severe psychological harm.
- Right to Request Restrictions: You can ask me not to use or share certain PHI for treatment, payment, or operations. I am not legally required to agree to your request, unless you pay for a service entirely out-of-pocket and request that I not share that information with your health insurer.
- Right to Confidential Communications: You can ask me to contact you in a specific way (for example, only call your cell phone, or send mail to a specific P.O. Box).
- Right to an Accounting of Disclosures: You can request a list of the times I have shared your PHI for reasons other than treatment, payment, or operations.
- Right to a Paper Copy: You have the right to a paper copy of this notice at any time, even if you agreed to receive it electronically on this website.
VII. Website and Digital Security Disclosures
- Contact Forms & Email: Please be advised that standard contact forms and unencrypted emails sent over the internet are not 100% secure. By submitting a contact form on this website, you acknowledge that you understand these communication risks.
- Third-Party Platforms: Any telehealth software or client portal used by this practice is fully HIPAA-compliant and protected under a signed Business Associate Agreement (BAA).
VIII. Complaints
If you believe your privacy rights have been violated, you may file a complaint with my office directly or with the Secretary of the U.S. Department of Health and Human Services (HHS). You will not be penalized or retaliated against for filing a complaint.
Tina Goodin, PhD. ABPP
Clinical Psychologist
Diplomate, American Board of Professional Psychology
Board Certified Psychoanalyst, CPS, IPA
Fellow, International Psychoanalytical Association
Good Samaritan Medical Center
Palm Beach, FL
561-301-1464