Fairfax Therapy Group - Notice of Privacy Practices
Effective Date: July 1, 2026
Practice Name: Fairfax Therapy Group
Contact: Joanna Marino (HIPAA Privacy Officer)
Phone:
Email:
Address:
This Notice describes how health information about you may be used and disclosed and how you can access this information. Please review it carefully.
Fairfax Therapy Group is committed to protecting the privacy and confidentiality of your health information. We are required by law to maintain the privacy of protected health information, provide you with notice of our legal duties and privacy practices, and follow the terms of the Notice currently in effect. The HIPAA Privacy Rule establishes national standards for protecting medical records and other individually identifiable health information. (HHS.gov)
Your Rights
You have the right to:
Get a copy of your health record
You may request to inspect or receive a copy of your health record. We will provide a copy or summary of your health information, usually within the timeframe required by law. We may charge a reasonable, cost-based fee when permitted.
Ask us to correct your health record
You may ask us to correct information in your record that you believe is inaccurate or incomplete. We may deny the request in certain circumstances, but we will explain the reason in writing.
Request confidential communications
You may ask us to contact you in a specific way, such as by phone, email, portal message, or mail, or to send information to a different address. We will make reasonable efforts to accommodate these requests.
Ask us to limit what we use or share
You may ask us not to use or share certain health information for treatment, payment, or healthcare operations. We are not always required to agree to the request. If you pay out of pocket in full for a service, you may ask us not to share information about that service with your health insurance plan for payment or healthcare operations.
Get a list of certain disclosures
You may request a list of certain times we have shared your health information, who we shared it with, and why. This is called an accounting of disclosures.
Get a copy of this Notice
You may request a paper or electronic copy of this Notice at any time. HIPAA requires covered providers with a direct treatment relationship to provide the Notice no later than the first service delivery and make a good faith effort to obtain acknowledgment of receipt. (HHS.gov)
Choose someone to act for you
If you have given someone legal authority to make healthcare decisions for you, or if someone is your legal guardian, that person may exercise your rights and make choices about your health information, consistent with applicable law.
File a complaint
You may file a complaint if you believe your privacy rights have been violated. You may contact us directly using the contact information above. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you may tell us your preferences about what we share. If you have a clear preference for how we share information in the situations below, please let us know.
You may tell us whether we may share information with family members, close friends, or others involved in your care. In emergencies or situations where you are unable to tell us your preference, we may share information if we believe it is in your best interest and consistent with applicable law and professional ethics.
We will not use or disclose your health information for marketing purposes or sell your health information without your written authorization, except as permitted by law.
How We May Use and Disclose Your Information
We may use and disclose your health information in the following ways:
Treatment
We may use or share your health information to provide, coordinate, or manage your care. For example, your therapist may consult with another clinician within the practice to support your treatment.
Payment
We may use and share your health information to bill and receive payment from health plans or other entities. For example, we may share diagnosis, session dates, and service codes with your insurance company so they can process claims.
Healthcare operations
We may use and share your health information for practice operations, such as quality review, documentation review, supervision, training, compliance, scheduling, and administrative functions.
Business associates
We may share information with third-party vendors who help us operate the practice, such as electronic health record systems, billing platforms, secure email vendors, telehealth platforms, or payment processors. These vendors are required to protect your information through business associate agreements when required by HIPAA.
Legal requirements
We may use or disclose your health information when required by federal, state, or local law.
Safety and emergencies
We may share information when necessary to prevent or reduce a serious and imminent threat to your health or safety or the health or safety of another person.
Abuse, neglect, or exploitation
We may disclose information to appropriate authorities if we reasonably believe disclosure is required by law related to suspected abuse, neglect, exploitation, or domestic violence.
Health oversight activities
We may share information with agencies authorized by law for audits, investigations, inspections, licensure, or disciplinary actions.
Court orders and legal proceedings
We may disclose information in response to a court order, subpoena, or other lawful process, as permitted or required by law.
Workers’ compensation
We may disclose health information as authorized by and to the extent necessary to comply with workers’ compensation laws.
Law enforcement
We may disclose health information for law enforcement purposes when permitted or required by law.
Psychotherapy Notes
Psychotherapy notes are treated with special protection under HIPAA. These are notes recorded by a mental health professional documenting or analyzing the contents of a counseling session and kept separate from the rest of the medical record. In most cases, we will not use or disclose psychotherapy notes without your written authorization, except as permitted by law, such as for certain treatment, training, legal defense, oversight, or safety-related purposes.
Communication by Email, Phone, Text, and Portal
Fairfax Therapy Group may use phone, email, text, portal messages, or telehealth platforms to communicate with you about scheduling, billing, forms, treatment logistics, and care-related matters. HIPAA allows covered healthcare providers to communicate electronically with patients when reasonable safeguards are used. (HHS.gov)
Because standard email and text messaging may carry privacy risks, we encourage clients to use secure communication methods when available. Please avoid sending detailed clinical or emergency information by unsecured email or text unless instructed otherwise.
Telehealth
If you receive services by telehealth, we use technology platforms intended to support privacy and confidentiality. You are responsible for choosing a private location for your sessions and using a secure internet connection when possible.
Minors and Personal Representatives
Privacy rights for minors may vary depending on federal and state law, the type of service provided, consent requirements, and the legal authority of parents or guardians. When working with minors, Fairfax Therapy Group will follow applicable law and clinical judgment regarding parent/guardian access, minor confidentiality, safety, and treatment participation.
Insurance and Billing
If you use insurance, we may share information with your insurance plan for payment and healthcare operations. This may include diagnosis, dates of service, type of service, provider information, and other information requested by the insurer. If you have questions about what information your insurance company may request or receive, please contact your insurance plan directly.
Uses and Disclosures Requiring Written Authorization
We will ask for your written authorization before using or disclosing your health information for purposes not described in this Notice, unless otherwise permitted or required by law. You may revoke an authorization in writing at any time, except to the extent we have already relied on it.
Changes to This Notice
We may change the terms of this Notice at any time. The new Notice will apply to all health information we maintain. The current Notice will be posted on our website and made available upon request.
Questions or Concerns
If you have questions about this Notice, your privacy rights, or how your health information is used, please contact:
Fairfax Therapy Group Privacy Contact
Email: [Insert Email]
Phone: [Insert Phone Number]
Address: [Insert Address]
You may also contact the U.S. Department of Health and Human Services Office for Civil Rights if you believe your privacy rights have been violated. HHS states that privacy notices are intended to help individuals understand privacy concerns, discuss them with providers, and exercise their rights. (HHS.gov)