Notice of Privacy Practices
Effective date: August 4, 2026
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.
Our Commitment to Your Privacy
In Harmony Therapy Group, PLLC, and Dr. Jai Ferrell, DMFT, LMFT, are required by law to maintain the privacy of your protected health information (PHI), to provide you with this notice describing our legal duties and privacy practices, and to follow the terms currently in effect.
How We May Use and Disclose Your Health Information
Your health information may be used and disclosed for the following purposes without additional written authorization:
- Treatment — to provide, coordinate, or manage your therapy care, including consultation with other treating providers when clinically appropriate.
- Payment — to bill and collect payment for services, including verifying insurance benefits or providing documentation for out-of-network reimbursement.
- Health Care Operations — for activities such as quality assurance, supervision (including associate-level supervision in California), and administrative practice functions.
- As Required by Law — including mandatory reporting of suspected abuse or neglect, threats of serious and imminent harm to self or others, and other disclosures required by state or federal law.
- Health Oversight, Legal, and Public Health Activities — as required by applicable regulatory, judicial, or public health authorities.
Uses and Disclosures Requiring Your Written Authorization
Other uses and disclosures not described above, including release of psychotherapy notes in most circumstances, will be made only with your written authorization. You may revoke that authorization in writing at any time, except to the extent action has already been taken in reliance on it.
Your Rights Regarding Your Health Information
- Right to Request Restrictions on certain uses and disclosures of your information.
- Right to Request Confidential Communications by an alternative means or at an alternative location.
- Right to Inspect and Copy your health record, with limited exceptions.
- Right to Request Amendment of your health record if you believe it is incomplete or inaccurate.
- Right to an Accounting of Disclosures made of your health information for certain purposes.
- Right to a Paper Copy of this notice upon request, even if you agreed to receive it electronically.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with this practice directly, or with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be penalized for filing a complaint.
Changes to This Notice
We reserve the right to change the terms of this notice and to make the new notice provisions effective for all health information we already maintain, as well as information we receive in the future. The current notice will be available upon request and posted on this website.
Contact Person
Dr. Jai Ferrell, DMFT, is the Privacy Officer for this practice. Questions or complaints regarding your privacy rights can be directed through the contact form on this website.
This notice is drafted from the standard HHS model Notice of Privacy Practices structure and has not been finalized or reviewed by a healthcare attorney or compliance professional. Washington and California both layer additional state-specific mental health confidentiality protections on top of HIPAA, so this document should be reviewed against those requirements, completed with your practice's specific details (privacy officer, business associates, complaint contact), and signed off before publishing or use with clients.