Notice of Privacy Practices

Heidi Stevenson, PhD, MSW
Effective Date: August 9, 2026

Your Information. Your Rights. My Responsibilities

This notice describes how information about your healthcare may be used and disclosed, how you can access that information, and the rights you have regarding your privacy.

Please review it carefully.

This Notice of Privacy Practices applies to protected health information that I create, receive, or maintain in connection with the therapy services I provide

Your Rights

When it comes to your health information, you have certain rights. I will help you exercise these rights when you ask.

Get an Electronic or Paper Copy of Your Record

You can ask to see or receive an electronic or paper copy of your clinical record and other health information I maintain about you. I will provide access to your information within the time required by law. In most circumstances, HIPAA requires action on a request within 30 days. When permitted by law, I may charge a reasonable, cost-based fee for copies. Certain information, including psychotherapy notes as specifically defined by HIPAA, may be treated differently from the rest of your clinical record.

Ask Me to Correct Your Record

If you believe health information in your record is incorrect or incomplete, you can ask me to amend it. I may deny the request in circumstances allowed by law. If I do, I will explain the decision to you in writing

Request Confidential Communications

You can ask me to contact you in a particular way or at a particular location. For example, you may ask me to use a particular phone number, email address, or mailing address. I will accommodate reasonable requests.

Ask Me to Limit What I Use or Share

You can ask me not to use or share certain health information for treatment, payment, or healthcare operations. I am not always required to agree to these requests. If I agree to a restriction, I will follow it except in circumstances permitted or required by law, including when information is needed to provide emergency treatment. If you pay in full out of pocket for a particular service and ask me not to disclose information about that service to your health plan for payment or healthcare operations, I will honor that request unless disclosure is required by law.

Get a List of Certain Disclosures

You can ask for an accounting of certain disclosures of your protected health information made during the six years before your request. The accounting does not include every disclosure. For example, certain disclosures made for treatment, payment, or healthcare operations are generally not included. You may receive one accounting during a 12-month period without charge. If you request another accounting within the same 12-month period, a reasonable cost-based fee may apply.

Get a Copy of This Notice

You can ask me for a paper or electronic copy of this Notice at any time, even if you previously agreed to receive it electronically.

Choose Someone to Act for You

If someone is legally authorized to act as your personal representative, that person may exercise your privacy rights on your behalf as permitted by law. I may need to verify that person's authority before acting on a request.

File a Privacy Complaint

If you believe your privacy rights have been violated, you can contact me using the information at the end of this Notice. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. I will not retaliate against you or treat you differently for asking about your privacy rights or filing a complaint.

Your Choices

For some health information, you can tell me what you would like me to share.

People Involved in Your Care

You can tell me whether you want me to share relevant information with a family member, close friend, or another person involved in your care or payment for your care. If you are unable to tell me your preference, I may make a limited disclosure when permitted by law and when I believe it is in your best interest.Because I provide mental health services, additional federal and Michigan confidentiality protections may apply to your information.

Marketing, Sale of Information, and Psychotherapy Notes

I do not sell your protected health information. I will obtain your written authorization before using or disclosing your protected health information for marketing when authorization is required by law. Most uses and disclosures of psychotherapy notes require your written authorization. Under HIPAA, psychotherapy notes have a specific definition and are different from ordinary progress notes or the rest of your clinical record.

Fundraising

I do not use your protected health information to contact you for fundraising.

How I May Use or Share Your Health Information

I may use or share your health information in the following circumstances when permitted or required by law.

To Provide Your Care

I may use your health information to provide therapy and may share appropriate information with another healthcare professional involved in your treatment when permitted by law. When Michigan law provides greater confidentiality protection than HIPAA, I will follow the more protective requirement.

Clinical Supervision

I may discuss information related to your care as part of required professional or clinical supervision. Information shared in supervision will be limited to what is reasonably necessary for supervision and will be handled confidentially.

To Receive Payment for Services

I may use or disclose information necessary to bill for services and receive payment. If you use health insurance, information may be provided to your health plan or others involved in processing or reviewing a claim. Information used for insurance purposes may include information such as your diagnosis, dates of service, type of service provided, and other information needed to process a claim or determine coverage

To Operate My Practice

I may use health information as necessary to operate my practice. This may include activities related to maintaining records, quality improvement, professional consultation, billing, auditing, legal or regulatory compliance, and practice administration when permitted by law.

Business Associates

I may use outside professionals or companies to perform services for my practice, such as electronic health records, billing, telehealth, secure technology, or other administrative services. When a person or company creates, receives, maintains, or transmits protected health information on my behalf and qualifies as a business associate under HIPAA, I will require the protections and agreements required by law.

Public Health and Safety

I may use or disclose health information when permitted or required by law for certain public health and safety purposes. These circumstances may include reporting suspected abuse or neglect or taking actions permitted or required by law when there is a serious threat to someone's health or safety. Michigan law also establishes circumstances in which mental health professionals have responsibilities when a client communicates a qualifying threat of physical violence toward an identifiable person.

When Required by Law

I may use or disclose your health information when federal or Michigan law requires me to do so. I will limit any disclosure to the information required or permitted by the applicable law.

Health Oversight

I may disclose information to an authorized health oversight agency when permitted or required by law. This can include activities related to professional licensing, healthcare regulation, audits, investigations, or compliance with privacy laws.

Legal Proceedings

I may receive a subpoena, court order, or other legal request for information. A subpoena does not necessarily mean that confidential therapy information will automatically be disclosed. I will evaluate the request under HIPAA, Michigan confidentiality and privilege law, and other applicable requirements before releasing information. When disclosure is legally required, I will disclose only the information required or permitted by law.

Law Enforcement and Government Requests

I may disclose health information for certain law-enforcement or government purposes when the disclosure is specifically permitted or required by law.

Workers' Compensation

I may use or disclose health information as authorized by and to the extent necessary to comply with workers' compensation laws or similar programs.

Medical Examiners, Coroners, and Funeral Directors

When permitted by law, I may disclose relevant health information to a coroner, medical examiner, or funeral director so that they can perform their legal duties.

Organ and Tissue Donation

When applicable and permitted by law, health information may be disclosed to organizations involved in organ, eye, or tissue donation and transplantation.

Research

I do not routinely use identifiable client information for research. If protected health information were used or disclosed for research, I would do so only when permitted by law, such as with your authorization or through another legally authorized research process.

Additional Protection for Mental Health Information in Michigan

Michigan law provides confidentiality and privilege protections for communications between social workers and their clients in addition to the protections provided by HIPAA. In general, communications between a registered or licensed social worker and a client are confidential and privileged, subject to exceptions established by law. Those exceptions include certain communications made as part of a required supervisory process, circumstances in which the client or an authorized representative waives the privilege, and disclosures otherwise permitted or required by law. When Michigan law provides greater privacy protection than HIPAA, I will follow the more protective requirement.

Substance Use Disorder Records

Certain substance use disorder records receive additional protection under federal law. To the extent that I receive or maintain records protected by 42 CFR Part 2, additional restrictions apply to their use and disclosure. Information contained in Part 2-protected records generally cannot be used or disclosed in a civil, criminal, administrative, or legislative investigation or proceeding against you unless the requirements of federal law are met, including the required written consent or appropriate court process. I do not use Part 2-protected information for fundraising

My Responsibilites

I am required by law to protect the privacy and security of your protected health information.

I am required to follow the duties and privacy practices described in the Notice that is currently in effect.

I will notify you as required by law if a breach occurs that may have compromised the privacy or security of your protected health information.

I will not use or disclose your health information in ways that are not described in this Notice unless you authorize me to do so in writing or another law permits or requires the use or disclosure.

If you give me written authorization, you may revoke that authorization in writing at any time. Revoking an authorization does not undo actions already taken in reliance on the authorization.

When Michigan law provides greater privacy protection than HIPAA, I will follow the more protective law.

Changes to This Notice

I may change the terms of this Notice and my privacy practices as permitted by law.

Any changes may apply to health information I already maintain as well as information I receive in the future.

If I make a material change, the updated Notice will be available on my website, in my office when applicable, and upon request.

Questions, Requests, or Privacy Complaints

If you have questions about this Notice, want to exercise one of your privacy rights, or want to make a privacy complaint, please contact:
Heidi Stevenson, PhD, MSW
Email: hello@heidistevenson.com
Phone: 989.403.5562

You may also file a complaint with:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775

You may also submit a complaint through the HHS Office for Civil Rights complaint system.

I will not retaliate against you for exercising your privacy rights or filing a complaint.