Effective Date: November 19, 2025
Modern Therapy CB
Therapist: Candice Beaton, LCSW
Phone: 708-252-3521
Your Privacy Matters
This Notice explains how your protected health information (PHI) may be used, shared, and protected, and it outlines your rights under the HIPAA Privacy Rule. My goal is to give you a safe, confidential space where you understand how your information is handled.
Your Rights
1. Right to Access Your Record
You can ask to see or receive an electronic or paper copy of the health information I have about you.
I will provide it within 30 days, and a reasonable, cost-based fee may apply.
2. Right to Request Corrections
If you believe something in your record is incomplete or inaccurate, you can request an amendment.
If I cannot make the change, I’ll explain why in writing within 60 days.
3. Right to Confidential Communication
You can request that I contact you in a specific way (for example: email only, no voicemail, or at a certain number).
I will honor all reasonable requests.
Please note that while I take every reasonable step to protect your privacy, confidentiality cannot be guaranteed when using electronic communication (such as email, text message, or telehealth platforms), because no digital method is ever 100% secure. I use secure, professional systems whenever possible, and will always discuss your preferences with you.
4. Right to Request Restrictions
You may ask me not to use or share certain information for treatment, payment, or healthcare operations.
I am not required to agree, but I will always consider your request and explain my decision.
5. Right to Know If I’ve Ever Shared Your Information
You can ask for a list of any times I’ve shared your health information for reasons other than providing your care, running my practice, or processing payments.
In my practice, these situations are rare and would only occur when required by law (such as a serious safety concern or mandated reporting).
You may request this list once every 12 months at no cost.
6. Right to a Copy of This Notice
You may also request a paper or emailed copy at any time.
7. Right to Choose a Representative
If someone has legal authority to act on your behalf (e.g., a guardian or healthcare proxy), I will treat that person as your representative.
8. Right to File a Complaint
If you believe your privacy rights have been violated, you may:
How I Use and Share Your Information
1. Treatment
To provide and coordinate your care.
This may include clinical documentation and—only with your written permission—consulting with other professionals involved in your care.
2. Payment
To process payments, provide receipts, or create superbills (if applicable).
3. Healthcare Operations
For practice management tasks such as scheduling, record-keeping, quality improvement, and secure electronic systems.
I do not sell your information and do not use your PHI for marketing or fundraising.
When I May Share Information Without Your Authorization
I may share PHI only when required or permitted by law, such as:
• Safety Concerns
If you are at risk of harming yourself or others, or if someone else is in danger.
• Mandated Reporting
If I suspect abuse or neglect of a child, dependent adult, or elder.
• Legal Requests
If ordered by a court, subpoena, or other lawful process (within legal limits).
• Health Oversight
For audits or compliance activities required by authorized agencies.
• Law Enforcement or Government Requests
Only in limited, legally permitted situations.
• Workers’ Compensation
If required to comply with workers’ comp laws.
Psychotherapy Notes
Your psychotherapy notes are kept separate from your general clinical record and have extra privacy protections.
They are never shared without your specific written authorization, except when required by law.
Uses and Disclosures That Require Your Authorization
Any use or sharing of your information not described in this notice will only occur with your written permission.
You may revoke that permission at any time, in writing.
My Responsibilities
I am legally required to:
- Maintain the privacy and security of your PHI
- Provide this Notice of Privacy Practices
- Notify you promptly if a breach occurs that may compromise your information
- Follow the terms of this Notice
- Use or disclose PHI only as described here or when required by law
Changes to This Notice
I may update this Notice as laws or practice policies change.
The most current version will always be available on my website, and you may request a copy at any time.
Questions? Contact Me
If you have questions about confidentiality, privacy, or your rights, please reach out:
Modern Therapy CB
Therapist: Candice Beaton, LCSW
Phone: 708-252-3521
