Effective date: 10/06/2026

THIS NOTICE DESCRIBES HOW HEALTH 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 Seventh House Mental Health Counseling PLLC ("Seventh House," "we," "us," or "our") and all of our clinicians.

I. OUR PLEDGE REGARDING YOUR HEALTH INFORMATION

We understand that your health information is personal, and we are committed to protecting it. We create a record of the care and services you receive from us. We need this record to provide you with quality care and to comply with legal requirements. This Notice applies to all records of your care created by our practice.

We are required by law to:

- Keep protected health information ("PHI") that identifies you private.

- Give you this Notice of our legal duties and privacy practices.

- Follow the terms of the Notice currently in effect.

- Notify you if a breach occurs that may have compromised the privacy or security of your information.

Where New York law provides greater protection for your health information than federal law, we follow New York law.

We may change the terms of this Notice, and changes will apply to all information we have about you. The current Notice will be available on our website, in our office, and upon request.

Couples, Family, and Group Therapy. When more than one adult participates in couples or family therapy, a shared record will be kept unless all participants request otherwise in writing. Information shared during joint sessions may become part of that shared record. Each participant keeps their individual rights under HIPAA. In group therapy, members agree to keep information about other members confidential, but we cannot guarantee that every member will do so. Please talk with your clinician about any concerns.

II. HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION 

The categories below describe ways we use and disclose health information. Not every use or disclosure is listed, but all permitted uses and disclosures fall within one of these categories.

Treatment. We may use and share your information to provide and coordinate your care. For example, clinicians within our practice may consult with one another or with clinical supervisors, and we may coordinate with other health care providers involved in your care, such as a prescribing medical provider for ketamine-assisted psychotherapy 

Payment. We may use and share your information to bill and receive payment for services, including submitting claims or superbills to your insurance plan when applicable.

Health Care Operations. We may use and share your information to run our practice, improve the quality of care, train and supervise clinicians, and work with business associates, such as our electronic health record and billing providers, who are required to protect your information.

Lawsuits and Disputes. If you are involved in a lawsuit, we may disclose health information in response to a court or administrative order. We may also disclose information in response to a subpoena, discovery request, or other lawful process, but only if efforts have been made to tell you about the request or to obtain an order protecting the information.

III. USES AND DISCLOSURES THAT REQUIRE YOUR AUTHORIZATION 

Psychotherapy Notes. Our clinicians may keep "psychotherapy notes" as defined in 45 CFR § 164.501. Any use or disclosure of these notes requires your written authorization unless it is:

a. For your clinician's use in treating you.

b. For use in training or supervising mental health practitioners.

c. For use in defending ourselves in legal proceedings you bring.

d. For use by the Secretary of Health and Human Services to investigate our compliance with HIPAA.

e. Required by law, limited to the requirements of that law.

f. Required by law for health oversight activities related to the originator of the notes.

g. Required by a coroner performing duties authorized by law.

h. Required to help avert a serious threat to the health and safety of others.

Marketing. We will not use or disclose your PHI for marketing purposes.

Sale of PHI. We will not sell your PHI

Other Uses. Any use or disclosure not described in this Notice will be made only with your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted on it.

IV. USES AND DISCLOSURES THAT DO NOT REQUIRE YOUR AUTHORIZATION

Subject to limits in the law, we may use and disclose your PHI without your authorization:

1. When required by state or federal law, limited to the requirements of that law.

2. For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone's health or safety.

3. For health oversight activities, including audits and investigations.

4. For judicial and administrative proceedings, including responding to a court or administrative order, although we prefer to obtain your authorization first.

5. For law enforcement purposes, including reporting crimes occurring on our premises.

6. To coroners or medical examiners performing duties authorized by law.

7. For approved research purposes.

8. For specialized government functions, such as military, national security, and correctional activities.

9. For workers' compensation purposes, as required by workers' compensation laws.

10. To remind you of appointments and to tell you about treatment options or other services we offer.

V. USES AND DISCLOSURES YOU MAY OBJECT TO

Disclosures to family, friends, or others. We may share your PHI with a family member, friend, or other person you identify as involved in your care or payment for your care, unless you object in whole or in part. In an emergency, your agreement may be obtained afterward.

VI. YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

The Right to Request Limits. You may ask us not to use or disclose certain PHI for treatment, payment, or health care operations. We are not required to agree, and we may decline if we believe it would affect your care. 

The Right to Restrict Disclosures for Services Paid in Full. You may ask us not to share PHI with your health plan for payment or operations purposes if the PHI relates solely to a service you paid for out of pocket in full. We will honor this request.

The Right to Choose How We Contact You. You may ask us to contact you in a specific way or at a different address. We will agree to all reasonable requests.

The Right to See and Get Copies of Your PHI. Other than psychotherapy notes, you may request an electronic or paper copy of your record. We will respond within 30 days of your written request and may charge a reasonable, cost-based fee.

The Right to a List of Disclosures. You may request a list of instances in which we disclosed your PHI for purposes other than treatment, payment, or health care operations, or disclosures you authorized. We will respond within 60 days. The list will cover the past six years unless you request a shorter period. The first list in a 12-month period is free. We may charge a reasonable, cost-based fee for additional requests.

The Right to Correct or Update Your PHI. If you believe your PHI contains a mistake or is missing important information, you may ask us to correct or add to it. If we decline, we will explain why in writing within 60 days. 

The Right to a Copy of This Notice. You may request a paper or electronic copy of this Notice at any time, even if you previously agreed to receive it electronically.

VII. QUESTIONS AND COMPLAINTS

If you have questions about this Notice or believe your privacy rights have been violated, please contact our Office:

Seventh House Mental Health Counseling PLLC

1123 Broadway, Suite 301, New York, NY 10010

hello@seventhhousepsychotherapy.com

(862) 208-2821

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, at www.hhs.gov/ocr/complaints. We will not retaliate against you for filing a complaint.