NOTICE OF PRIVACY PRACTICES

This Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

I. OUR COMMITMENT TO YOUR PRIVACY

As your mental health therapist, I am committed to maintaining the privacy and confidentiality of your personal information. The trust you place in me is of utmost importance, and I strive to ensure the security of your sensitive information. 

II. INFORMATION COLLECTED

In the course of providing mental health services, I may collect and maintain various types of personally identifiable information, including but not limited to your name, contact details, medical history, and other relevant details.

III. USES AND DISCLOSURES OF YOUR INFORMATION

Your information may be used for treatment purposes, payment processing, and healthcare operations. In certain situations, I may disclose your information to comply with legal requirements or for other necessary purposes with your consent.

IV. YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

You have the right to:

Access: Request access to your health information.
Amend: Request amendments to your health information if you believe it is inaccurate or incomplete.

Restrictions: Request restrictions on certain uses and disclosures of your information.

Confidential Communications: Request confidential communication of your information.

V. OUR RESPONSIBILITIES

I am committed to:

• Safeguarding your information.

• Providing you with this Notice of Privacy Practices.

• Abiding by the terms outlined in this notice.
  
  

VI. CONTACT INFORMATION

If you have any questions or concerns about the privacy of your information or this notice, please contact:

Diana Martins, LCSW-C
Psychotherapist
Mental Health Services of Maryland, LLC
12345 Parklawn Drive
North Bethesda, MD 20852

T: (301)284-0350
E: dmartins@mhsmd.com

VII. CHANGES TO THIS NOTICE

I reserve the right to change this Notice of Privacy Practices and will promptly update you regarding any material changes.

VIII. EFFECTIVE DATE

This Notice of Privacy Practices is effective as of July 17, 2023.

Thank you for entrusting me with your mental health. Your privacy is a priority, and I am dedicated to ensuring the confidentiality and security of your information.