Notice of Privacy Practices

Dr. Judith Rand - Outpatient Psychology Practice

Effective Date: March 5, 2026

This Notice describes how medical and mental health information about you may be used and disclosed and how you can access this information. Please review it carefully.

Dr. Judith Rand and this practice are committed to protecting the privacy and confidentiality of your health information. Federal law (HIPAA) and Arizona state law require us to safeguard your Protected Health Information (PHI) and inform you of your rights regarding that information.

Protected Health Information includes information that identifies you and relates to your physical or mental health condition, treatment, or payment for services.

Our Legal Responsibilities

Under federal and Arizona law, this practice is required to:

* Maintain the privacy of your Protected Health Information * Provide you with this Notice of Privacy Practices * Follow the privacy practices described in this notice * Notify you if a breach of unsecured health information occurs * Obtain your authorization for uses of information not described in this notice

This notice applies to all records of your care maintained by this practice.

How We May Use and Disclose Your Information

1. Treatment

We may use and share your health information to provide, coordinate, or manage your mental health care.

Examples include:

* Consultation with other healthcare professionals involved in your care * Referrals to specialists * Coordinating treatment with primary care physicians

Arizona law recognizes the confidentiality of communications between a psychologist and a patient under A.R.S. ยง32-2085, meaning such communications are generally privileged unless you provide written consent or an exception applies.

2. Payment

We may use your health information to bill and collect payment for services.

This may include sharing information with insurance companies such as:

* Blue Cross Blue Shield * Aetna * Medicare

Information shared for billing may include diagnosis codes, dates of service, and treatment type.

3. Healthcare Operations

We may use your information for practice operations such as:

* Quality assessment * Professional supervision or consultation * Administrative and business activities * Compliance and auditing

Only the minimum necessary information will be used.

4. Appointment Reminders and Communication

We may contact you to remind you about appointments or provide information about treatment.

Communication may occur through:

* Phone * Email * Text message * Mail

You may request restrictions or alternative communication methods.

Situations Where Disclosure May Be Required by Law

Arizona law and federal regulations sometimes require disclosure of health information without your authorization.

Duty to Warn / Protect

Under Arizona law and professional ethics, a mental health professional may disclose information if necessary to prevent a serious and imminent threat of harm to you or others.

Abuse or Neglect Reporting

Arizona law requires reporting suspected abuse or neglect of:

* Children * Vulnerable adults * Elderly individuals

These reports may be made to appropriate protective services agencies.

Court Orders or Legal Proceedings

Information may be disclosed if required by:

* A court order * Subpoena * Legal proceedings

Whenever possible, we will limit disclosure to the minimum required.

Law Enforcement

Information may be disclosed to law enforcement when required by law, such as:

* Reporting certain injuries * Locating missing persons * Complying with a lawful investigation

Public Health and Safety

Information may be shared with public health authorities when required for:

* Disease prevention * Public safety * Health oversight activities

Uses That Require Your Written Authorization

Certain uses and disclosures require your written permission.

These include:

* Release of psychotherapy notes * Use of information for marketing purposes * Sharing information with family members or others not involved in your care * Any other use not described in this notice

You may revoke your authorization at any time in writing.

Your Rights Regarding Your Health Information

Right to Access Your Records

You have the right to request a copy of your health records.

Requests must be submitted in writing. A reasonable fee may apply for copying.

Right to Request Corrections

If you believe information in your record is incorrect or incomplete, you may request an amendment.

Right to Request Restrictions

You may request restrictions on certain uses or disclosures of your information. While we will consider your request, we may not always be able to agree.

Right to Confidential Communications

You may request that we contact you in a specific way, such as:

* Only calling a certain phone number * Communicating by email * Sending mail to a different address

Right to Receive This Notice

You have the right to receive a paper or electronic copy of this notice at any time.

Right to an Accounting of Disclosures

You may request a list of certain disclosures made outside treatment, payment, or healthcare operations.

Filing a Complaint

If you believe your privacy rights have been violated, you may file a complaint with:

Dr. Judith Rand

1854 S Dobson Rd, Suite 106

Mesa, AZ 85202

480-466-7010

[email protected]

You may also file a complaint with the U.S. Department of Health and Human Services:

Office for Civil Rights (OCR) https://www.hhs.gov/ocr

You will not be penalized or retaliated against for filing a complaint.

Changes to This Notice

We reserve the right to modify this Notice of Privacy Practices. Any changes will apply to all health information maintained by the practice.

Updated versions will be posted on our website.

Acknowledgment of Receipt

Patients may be asked to sign a form acknowledging receipt of this Notice of Privacy Practices.

If you have any questions about this notice or how your information is protected, please contact our office.