**Notice of Privacy Practices**
Emily Jones, LMFT #97024
Effective Date: December 1, 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.
**1. My Commitment to Your Privacy**
I am dedicated to maintaining the privacy of your protected health information (PHI). I am required by law to provide you with this Notice, maintain the privacy of your PHI, and follow the terms described here.
**2. How I May Use and Disclose Your Health Information**
- **Treatment**: To provide you with therapy, coordinate care with other providers (with your consent), or consult with supervisors/clinical consultants (de-identified when possible).
- **Payment**: To bill insurance companies, provide superbills, or collect payment.
- **Health Care Operations**: Quality improvement, training, or legal/compliance activities.
- **Other Permitted Uses** (only when required or allowed by law):
– Report abuse, neglect, or domestic violence
– Respond to public health or health oversight activities
– Comply with court orders or law enforcement requests
– Prevent serious threat to health or safety
**3. Uses and Disclosures That Require Your Written Authorization**
Anything not listed above (e.g., marketing, sale of PHI, most uses of psychotherapy notes) requires your signed authorization.
**4. Your Rights Regarding Your Health Information**
You have the right to:
- Request restrictions on how I use or disclose your PHI (I will try to honor reasonable requests)
- Receive confidential communications (e.g., by email instead of phone)
- Inspect and receive a copy of your record (electronic or paper)
- Request an amendment if you believe something is incorrect
- Receive an accounting of certain disclosures
- Receive a paper or electronic copy of this Notice
- File a complaint with me or the U.S. Department of Health and Human Services if you believe your privacy rights have been violated
**5. Website & Technology Practices**
- My website collects only basic contact information (name, email, phone) when you fill out forms or book appointments.
- I use HIPAA-compliant platforms (SimplePractice, Google Workspace with BAA, etc.).
- Cookies and analytics are used only for site performance (no PHI is tracked).
**6. Security of Your Information**
All telehealth sessions are conducted on end-to-end encrypted platforms. Emails containing PHI are encrypted or sent through the secure client portal. I conduct regular risk assessments and train on privacy and security.
**7. Changes to This Notice**
I may change this Notice at any time. The new version will be posted on my website and provided at your next session.
**8. Questions or Complaints**
If you have questions or wish to file a complaint, please contact me:
Emily Jones
Email: emilyjones@pivotpointcbt.com
Phone: 916-259-3187
Mailing Address: 185 E. Main St Unit 1194 Grass Valley, CA 95945
You may also file a complaint with the Secretary of HHS at:
https://www.hhs.gov/hipaa/filing-a-complaint
I will not retaliate against you for filing a complaint.
**Acknowledgment**
I will ask you to acknowledge receipt of this Notice during our first session (electronic signature through the client portal).
You can verify a CA therapy provider license via: https://bbs.ca.gov/licensees/verify.html