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NOTICE: I keep a record of the health care services I provide you.  You may ask me to see and copy that record.  You may also ask me to correct that record.  I will not disclose your record to others unless you direct me to do so or unless the law authorizes or compels me to do so.  You may see your record or get more information about it at 5224 Olympic Drive, Suite 107 Gig Harbor, Washington 98335


Here at Oceans of Emotions, PLLC, I am committed to protecting the confidentiality of our clients’ medical and psychological information. This Notice of Privacy Practices describes how I may use and disclose your medical and psychological information and your rights concerning your medical and psychological information. This Notice of Privacy Practices is provided to you pursuant to the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations (“HIPAA”).


This Notice of Privacy Practices applies to protected health information (PHI) created or received by Oceans of Emotions, PLLC that identifies you. This could include information that relates to your past, present or future physical or mental condition, relates to the care provided, or relates to the past, present, or future payment for your healthcare. For example, your PHI includes your treatment plan, assessments, progress notes, test results, diagnoses, legal matters, health information from other providers, and financial information that could identify you. I keep a record of the health care services I provide you. The information contained in your medical record serves as a means of communication among the many health professionals who contribute to your care.


The following identifies how we may use and disclose your PHI:


  1. For Treatment: We can use your health information and share it with other professionals who are treating you. Your therapist will record your information in your medical record and may need to know and/or discuss your health history with other practitioners to help decide what treatment or assessment is appropriate for you.

  2. For Payment Purposes: We can use and share your health information to bill and get payment from health plans or other entities. If you have health insurance and we bill your insurance directly, we will include information that identifies you, as well as your diagnosis, the procedures performed, and supplies used, so that we can be paid for the treatment provided.

  3. For Operations: We can use and share your health information to run our practice, improve your care, and contact you when necessary. We may disclose your PHI to maintain operations of this mental health clinic. This could include evaluating the quality of health care services that you have received and/or evaluate the performance of professionals who have provided health care services to you.

  4. Contact You for Information: Your personal information may be used to call you or send you a letter to remind you about appointments, provide diagnostic results, inform you about treatment options, or advise you about other health-related benefits and services.

  5. Consultation with Business Associates: We may provide your PHI to our attorneys, accountants, consultants, and others to make sure we are following laws that affect us.

  6. For Disaster Relief: We may disclose PHI information such as your name, city of residence, age, gender, and general condition to a public or private disaster relief organization to assist disaster relief efforts, unless you object at the time.

  7. For Public Health Activities: Many functions performed or authorized by government agencies promote and protect the public’s health and may require us to disclose your PHI. We have an obligation to health oversight agencies to report certain diseases or exposure to disease, injuries, conditions, and vital events such as deaths.  We may use and disclose your PHI as needed to comply with federal and state laws governing workplace safety.

  8. For Military Activity and National Security: We may use or disclose the PHI of armed forces personnel to the applicable military authorities when they believe it is necessary to carry out military missions. We may also disclose your PHI to authorized federal officials for national security and intelligence activities or for protection of the President and other government officials and dignitaries.

  9. Data Breach Notification Purposes: We may use or disclose your PHI to provide legally required notices of unauthorized access to or disclosure of your health information.

  10. For Law Enforcement/Lawsuits/Legal Disputes/Workers’ Compensation: We may disclose PHI to authorized officials for law enforcement purposes (i.e., to respond to a search warrant, reporting a crime on our premises or help identify or locate someone). We may use and disclose PHI if responding to a court or administrative order, a subpoena, or a discovery request. PHI may also be disclosed to the extent permitted by law without your authorization to defend a lawsuit or arbitration. We can use or share information about you for workers’ compensation claims.

  11. Disclosures Required or Authorized by Law: We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law. We may disclose PHI to report a reasonable belief that a child has suffered abuse or neglect [RCW 26.44.030]. For reporting purposes, a child is anyone under the age of 18 [RCW 26.44.020]. To report a reasonable belief that abandonment, abuse, financial exploitation, or neglect of a vulnerable adult has occurred [RCW 74.34.035 and RCW 5.60.060(9)(d)]. To prevent or minimize an imminent danger to the health or safety of the patient or any other person [RCW 5.60.060(9)(e)]

  12. To Coroners, Medical Examiners or Funeral Directors: We may disclose PHI to a coroner or medical examiner to determine cause of death or for other official duties.

  13. Do Research: We can use or share your information for health research.

  14. Respond to Organ and Tissue Donation Requests: We can share health information about you with organ procurement organizations


Except for those uses and disclosures described above, we will not use or disclose your PHI without your written authorization. Oceans of Emotions, PLLC requires your written authorization for each individual entity for sale of your information, most sharing of psychotherapy notes, and marketing purposes.

You can change your mind at any time about how you authorize us to use your PHI unless disclosure is required for us to obtain payment for services already provided, we have otherwise relied on the authorization, or the law prohibits revocation.

In the cases that require your written authorization, you have both the right and choice to give us permission to:

  • Share information with your family, close friends, or others involved in your care.

  • Share information in a disaster relief situation.

  • Include your information in a hospital directory

  • Contact you for fundraising efforts (We may contact you for fundraising efforts, but you can tell us not to contact you again).


If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.



 Oceans of Emotions, PLLC is required by both federal and state law, with certain exceptions, to maintain the confidentiality of information you share with staff.

When it comes to your protected health information (PHI), you have the right to:


  1. See and Receive an Electronic or Paper Copy of Your Health Information: In most cases, you have the right to review and receive a copy of certain healthcare information including certain medical and billing records, except for psychotherapy notes and other exceptions provided by law. If you request a copy of the information, we may charge a fee for the costs of copying, mailing, and/or other supplies associated with your request.

  2. Ask For a Change or Addition to Your Health Information: If you believe that information in your record is incorrect or that important information is missing, you have the right to request in writing that we make a correction or add information. You must include a reason for the amendment in your request. We may say “no” to your request, but we’ll tell you why in writing within 60 days and a copy of your request will be added to your record.

  3. Right to Receive Confidential Communications by Alternative Means and at Alternative Locations: You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. For instance, you may ask that we contact you at your campus/home address/phone, rather than work. We will accommodate reasonable requests. (NOTE: Email is NOT a confidential means of communication.)

  4. Request limits on uses and disclosures of your PHI: You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. You may not limit the uses and disclosures that we are legally required or allowed to make.

  5. Get a list of those with whom we’ve shared information with except for disclosures exempted by law: You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

  6. Ask for a paper or electronic copy of this Notice: You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

  7. Choose someone to act for you: If you have been given medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.

  8. Right to Rescind: You may, in writing, withdraw your consent to release confidential information at any time. However, if disclosures have already been made based on your earlier consent, these disclosures cannot be recovered or undone.

  9. File a complaint if you feel like your privacy rights have been violated: You can complain if you feel we have violated your rights by contacting us using the information on the top of this page of this document. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting We will not retaliate against you for filing a complaint.




State and federal laws apply to certain classes of patient health information. For example, additional protections may apply to information about sexually transmitted diseases, drug and alcohol abuse treatment records, mental health records, and HIV/AIDS information. When required by law, we will obtain your authorization before releasing this type of information. In certain circumstances, a minor (under 18 years of age) patient’s health information may receive additional protection. For your protection, we adhere to WAC 246-924-363 & RCW 70.02.230.




  • We are required by law to maintain the privacy and security of your protected health information.


  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.


  • We must follow the duties and privacy practices described in this notice and give you a copy of it.


  • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.


For more information see:


Changes to the Terms of This Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.


EFFECTIVE DATE: June 11, 2023

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