Notice of Privacy Practices
Effective Date: 12/27/2025
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.
Our Legal Duty
The Intimacy Room Marriage and Family Therapy PLLC is required by law to maintain the privacy of your protected health information and to provide you with this Notice of Privacy Practices.
Protected health information refers to information about you that may identify you and relates to your physical or mental health condition, the provision of healthcare services to you, or payment for those services.
We are required to follow the terms of this notice and to notify you if a breach of your unsecured protected health information occurs.
How We May Use and Disclose Your Information
We may use and disclose your protected health information for the following purposes:
Treatment
We may use your information to provide, coordinate, or manage your mental health treatment and related services.
Payment
We may use and disclose your information to obtain payment for services provided to you.
Healthcare Operations
We may use your information for administrative, operational, and quality improvement purposes necessary to run the practice.
As Required by Law
We may disclose information when required to do so by federal, state, or local law.
Public Safety and Legal Obligations
We may disclose information when necessary to prevent serious harm to you or others, in cases of suspected abuse or neglect, or in response to a valid court order or subpoena.
Your Rights Regarding Your Health Information
You have the right to:
Request access to your medical records
Request corrections to your health information
Request restrictions on certain uses or disclosures
Request confidential communications
Receive a paper or electronic copy of this notice
Requests must be submitted in writing. We may deny certain requests as permitted by law.
Confidentiality and Its Limits
Confidentiality is a core component of therapy. There are legal and ethical limits to confidentiality, including but not limited to:
Risk of harm to yourself or others
Suspected abuse or neglect of a child, elder, or dependent adult
Court orders or other legal requirements
These disclosures are made only as required by law.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with The Intimacy Room Marriage and Family Therapy PLLC or with the U.S. Department of Health and Human Services.
You will not be penalized or retaliated against for filing a complaint.
Contact Information
If you have questions about this notice or your privacy rights, please contact:
The Intimacy Room Marriage and Family Therapy PLLC
Licensed Marriage and Family Therapy Practice
State of New York
Email: jess@theintimacyroom.com
Changes to This Notice
We reserve the right to change the terms of this notice at any time. Any changes will apply to all protected health information we maintain. Updated notices will be available on our website.