[ATTORNEY REVIEW REQUIRED — Placeholder content. Do not consider this a legally sufficient notice of privacy practices until reviewed by licensed counsel.]

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.

This Notice applies to clients of Fanshen Thompson, LCSW ("we", "us", "our"). It does not apply to general visitors to fanshenthompson.com — visitor information is governed by our Privacy Policy.

1. Our Commitment to Your Privacy

We are required by law to maintain the privacy of your protected health information (PHI), provide you with this Notice describing our legal duties and privacy practices, and notify you in the event of a breach of unsecured PHI.

2. Uses and Disclosures of PHI

We may use and disclose your PHI for the following purposes without your specific authorization:

• Treatment. To provide, coordinate, or manage your therapy services.
• Payment. To bill and collect payment for services.
• Healthcare Operations. Quality assessment, training, licensing, audits, and similar internal activities.
• Required by Law. When disclosure is required by federal, state, or local law.
• Public Health and Safety. To prevent serious threats to health or safety.
• Mandatory Reporting. Suspected abuse, neglect, or exploitation of children, elders, or dependent adults; threats of harm to self or identifiable others.

All other uses and disclosures require your written authorization, which you may revoke at any time in writing.

3. Your Rights

You have the right to:

• Inspect and obtain a copy of your PHI.
• Request a correction of inaccurate PHI.
• Request restrictions on certain uses and disclosures.
• Request confidential communications by alternative means or locations.
• Receive an accounting of certain disclosures.
• Receive a paper copy of this Notice on request.
• File a complaint with us or with the U.S. Department of Health and Human Services if you believe your privacy rights have been violated.

4. Our Duties

We are required by law to maintain the privacy of your PHI and to abide by the terms of this Notice currently in effect. We reserve the right to change the terms of this Notice and to make the new provisions effective for all PHI we maintain.

5. Complaints

You may file a complaint by contacting us at the address below or with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

6. Contact

Fanshen Thompson, LCSW
Berkeley, California (online practice)
fanshen@fanshenthompson.com