Privacy & Disclosures | Georgina (Gina) Holden, LMFT

Notice of Privacy Practices (HIPAA)

This notice describes how health information about you may be used and disclosed, and how you may access this information. Please review it carefully.

My Commitment to Your Privacy

I am committed to protecting your health information. I create records of the care and services you receive in order to provide quality care and comply with legal requirements. I am required by law to keep your protected health information (PHI) private, to provide you with this notice, and to follow its terms.

How I May Use Your Health Information

I may use or disclose your health information in the following circumstances without your written authorization:

Treatment: To provide, coordinate, or consult regarding your care with other licensed health care providers involved in your treatment.
Legal requirements: When required by state or federal law, including mandatory reporting of suspected child, elder, or dependent adult abuse.
Safety: To prevent or reduce a serious and imminent threat to your health or safety, or the health or safety of others.
Court orders: In response to a court or administrative order, subpoena, or other lawful process.
Appointment reminders: To contact you regarding your upcoming appointments.

Uses That Require Your Authorization

I will not use or disclose your health information for marketing purposes, and I will never sell your health information. Psychotherapy notes require your written authorization before they may be shared, except in limited circumstances required by law.

Your Rights

You have the right to request limits on how I use or disclose your information.
You have the right to request and receive a copy of your health records.
You have the right to request corrections to your records.
You have the right to receive a paper or electronic copy of this notice at any time.
You have the right to a list of disclosures I have made of your information.

Questions? If you have questions about this notice or your privacy rights, please contact me directly at therapy@ginaholden.com or 916-837-8565.

Good Faith Estimate & Payment Policy

Under the No Surprises Act, you have the right to receive a Good Faith Estimate of the expected cost of your care before services begin.

Your Right to a Good Faith Estimate

You have the right to receive a Good Faith Estimate explaining how much your mental health care will cost. You can ask your health care provider for a Good Faith Estimate before you schedule a service. For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises.

My Payment Policy

Payment is expected in full at the time of service. I will never send a bill for more than the cost of one agreed-upon session fee. Because payment is collected at the time of service, you will not receive unexpected bills or charges after your appointment. The fee for your sessions will be clearly agreed upon before we begin working together.

Session fees vary by service type. Please visit the Fees page for current rates, or contact me directly to discuss your specific situation.