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Notice of Privacy Practices

Effective date: September 17, 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.

This Notice applies to protected health information as defined under HIPAA. Personal information collected through the ordonezcounseling.com website that is not protected health information is governed by our Privacy Policy.

1. Who we are

This Notice describes how Ordonez Counseling, a Licensed Clinical Social Worker Corporation ("the Practice," "we," "us," or "our") and its contracted clinicians collect, use, and disclose your protected health information ("PHI"). Together with its contracted clinicians, the Practice is part of an organized health care arrangement that jointly uses and discloses PHI to carry out treatment, payment, or health care operations and for other purposes permitted or required by law. This Notice applies to the clinical services the Practice provides, including immigration evaluations and therapy (the "Services").

The Practice may engage a management or technology services company to provide administrative support. Any such company that handles PHI on our behalf does so as our Business Associate under HIPAA, under a written agreement that protects your information.

2. Effective date

This Notice is effective as of the date listed above and will remain in effect until we replace it. We must abide by the terms of this Notice while it is in effect.

PHI is information about you that may be used to identify you and that relates to your past, present, or future physical or mental health condition; the provision of health care to you; or your past, present, or future payment for the provision of health care.

3. Information we collect about you

We collect PHI to provide you with the Services, from the following sources: directly from you, such as information you provide when requesting and receiving the Services, including interview responses and standardized instruments; indirectly from you, such as through records you or your representative provide; and from third parties involved in your care or payment for care, such as your attorney with your authorization.

4. When we use and disclose your information

To provide you with the Services, we use and disclose your PHI for the following purposes:

  • Treatment. To provide you with the Services, including sharing PHI among the Practice's clinicians involved in your evaluation or care and coordinating a referral.
  • Payment. To collect payment and for other payment-related purposes, including through our payment processors.
  • Health care operations. To operate our practice, including quality review, clinical supervision, training, credentialing, and audits.

We may also use PHI to: engage third parties to assist with our payment and health care operations, in which case we require a written agreement that protects the PHI and provide only the minimum necessary; communicate with family members and others involved in your care or payment for your care to the extent legally authorized; and create de-identified and aggregate information to be used for any lawful purpose.

5. Evaluation reports

When you engage the Practice for an immigration evaluation, the resulting report is released to you and to the attorney or representative you designate in writing, and to no one else without your written authorization or as required by law. Your written authorization may be revoked in writing at any time, except to the extent the Practice has already acted on it.

6. When we may or must disclose your information without your authorization

In certain limited circumstances, we may be permitted or required by law to use or disclose your PHI without your authorization, including: for public health activities; to report suspected abuse or neglect of a child, elder, or dependent adult; for judicial and administrative proceedings, such as responding to court orders and lawful process; to prevent or lessen a serious and imminent threat of harm to a person or the public, including by contacting your emergency contact, local crisis services, or emergency responders at your location; when required by law or for law enforcement purposes; for state and federal health oversight activities, such as licensing and disciplinary action; to coroners, medical examiners, and funeral directors in limited circumstances; for research approved by an institutional review board; for specialized government functions; and for workers' compensation claims.

7. When we need your authorization to use or disclose PHI

Your written authorization is required prior to: any use or disclosure of psychotherapy notes, except as permitted by law; use or disclosure of PHI for marketing purposes; and any sale of PHI. We will not use or disclose PHI for these purposes, or for any other purpose not described in this Notice, without your written authorization. You have the right to revoke any authorization you previously provided, except to the extent we have already relied on it. With regard to deceased individuals, we comply with the HIPAA Privacy Rule's requirements for uses and disclosures of PHI for a period of 50 years following death.

8. Special protections

Certain information, including psychotherapy notes and, where applicable, substance use disorder treatment records, has additional protections under federal and state law. Where state law is more protective of your information than HIPAA, we follow state law.

9. Your rights regarding your information

  • Right to access PHI. With certain exceptions, you have the right to review and obtain a copy of your PHI, including an electronic copy, by emailing info@ordonezcounseling.com. We may charge a reasonable, cost-based fee. In limited circumstances we may deny your request; if so, we will inform you of the reason and whether you have the right to have the denial reviewed by a licensed health care professional who did not participate in the original decision.
  • Right to request amendment. You have the right to request that we amend your PHI if you believe it is inaccurate or incomplete, by emailing info@ordonezcounseling.com. If we deny your request, you may submit a statement of disagreement for inclusion in your record.
  • Right to request confidential communications. You may request that we communicate with you about PHI by alternative means or at an alternative location. We will accommodate reasonable requests.
  • Right to request restrictions. You may request restrictions on certain uses and disclosures of your PHI. We are not required to agree to all restrictions, but we must agree not to disclose PHI to your health plan for services you have paid for in full out of pocket, upon your request.
  • Right to an accounting of disclosures. You have the right to receive an accounting of our disclosures of your PHI, except disclosures for treatment, payment, health care operations, and certain other purposes. Your first accounting in any 12-month period is free; we may charge a reasonable fee for additional requests within that period.
  • Right to a paper copy. You have the right to request a paper copy of this Notice at any time, even if you agreed to receive it electronically.
  • Right to file a complaint. If you believe your privacy rights have been violated, you may file a complaint by emailing our Privacy Officer at info@ordonezcounseling.com. You also have the right to file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints. You will not be retaliated against for filing a complaint.

10. Our duties regarding your PHI

We are required by law to maintain the privacy and security of PHI, to provide notice of our legal duties and privacy practices with respect to PHI, to notify affected individuals following any breach of unsecured PHI, and to abide by the terms of this Notice currently in effect.

11. Changes to this Notice

We reserve the right to change this Notice at any time. If we change this Notice, we will post the new version at ordonezcounseling.com/notice-of-privacy-practices and make it available upon request. New terms will apply to all PHI we maintain.

12. Contact

For additional information about our privacy practices, contact our Privacy Officer: Ordonez Counseling, a Licensed Clinical Social Worker Corporation · 2108 N Street, Suite N, Sacramento, CA 95816 · info@ordonezcounseling.com