Notice of Privacy Practices

Effective Date: July 12, 2026

THIS NOTICE DESCRIBES HOW YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Mary O. Smith, DSW, LCSW is committed to protecting the privacy of your protected health information (PHI) in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and other applicable federal and state laws.

Uses and Disclosures of Your Health Information

Your protected health information may be used or disclosed for the following purposes:

Treatment

Your information may be used to provide, coordinate, or manage your mental health care.

Payment

If applicable, your information may be used to obtain payment for services provided.

Health Care Operations

Your information may be used for administrative purposes, quality improvement, licensing, accreditation, and other activities necessary to operate the practice.

Other Uses and Disclosures

Your information may also be disclosed when required or permitted by law, including but not limited to:

Suspected abuse, neglect, or exploitation
Court orders or legal proceedings
Serious threats to your health or safety or the safety of others
Certain public health reporting requirements
Workers' compensation claims, when applicable

Any other use or disclosure of your protected health information will require your written authorization unless otherwise permitted or required by law.

Your Rights

You have the right to:

Request access to your health records.
Request corrections to your health records.
Request restrictions on certain uses or disclosures.
Request confidential communications.
Receive an accounting of certain disclosures.
Receive a paper or electronic copy of this Notice.
File a complaint if you believe your privacy rights have been violated.

Complaints

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

Mary O. Smith, DSW, LCSW

The U.S. Department of Health and Human Services, Office for Civil Rights.

You will not be retaliated against for filing a complaint.

Changes to This Notice

This Notice may be updated from time to time. The most current version will always be available through this website and upon request.

Contact Information