Notice of Privacy Practices
Effective Date: January 1, 2026
Last Reviewed: January 1, 2026
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
About This Notice
This Notice of Privacy Practices describes how Vineel Maharaj, Licensed Marriage and Family Therapist #123091 ("I," "me," "my," or "therapist"), may use and disclose your Protected Health Information (PHI) to carry out treatment, payment, or healthcare operations, and for other purposes permitted or required by law.
This notice also describes your rights regarding your health information and how you can access, amend, or control how your information is used or shared.
I am required by law to:
Maintain the privacy of your Protected Health Information
Provide you with this Notice of my legal duties and privacy practices
Follow the terms of the Notice currently in effect
Notify you if there is a breach of your unsecured PHI
Important: For information about how we handle website data, cookies, and marketing communications, please see our separate Privacy Policy.
I. What is Protected Health Information (PHI)?
Protected Health Information includes any individually identifiable health information that I create, receive, maintain, or transmit in any form (electronic, paper, or oral) in the course of providing therapy services to you. This includes:
Information about your mental health condition, diagnosis, or symptoms
Information about mental health services you receive from me
Information about past, present, or future payment for mental health services
Personal identifiers such as name, address, date of birth, Social Security number
II. How I May Use and Disclose Your PHI
A. Uses and Disclosures for Treatment, Payment, and Healthcare Operations
I may use and disclose your PHI without your written authorization for the following purposes:
Treatment
I may use and disclose your PHI to provide, coordinate, or manage your mental health care and related services. This includes:
Providing psychotherapy and related treatment
Coordinating care with other healthcare providers (with your consent)
Consulting with other licensed mental health professionals about your case
Referring you to other providers or specialists when appropriate
Providing information to family members or others involved in your care (with your consent)
Example: If I consult with a psychiatrist about your medication needs, I would share relevant PHI to ensure coordinated care.
Payment
I may use and disclose your PHI to obtain payment for services provided, including:
Billing and collection activities
Processing credit card or HSA/FSA payments
Providing superbills for insurance reimbursement
Verifying insurance coverage and benefits (if applicable)
Responding to insurance company inquiries about treatment
Example: If you request a superbill for insurance reimbursement, I will include your diagnosis, dates of service, and procedure codes.
Healthcare Operations
I may use and disclose your PHI for healthcare operations purposes, including:
Quality assessment and improvement activities
Training and supervision of mental health professionals or students
Conducting or arranging for legal, auditing, or consulting services
Business planning and management activities
Compliance with legal and regulatory requirements
Example: I may use de-identified or aggregated information to analyze treatment outcomes and improve the quality of care I provide.
B. Uses and Disclosures That Require Your Written Authorization
The following uses and disclosures require your specific written authorization:
1. Psychotherapy Notes
I maintain two types of clinical documentation:
Treatment Records: Progress notes, diagnoses, treatment plans, medications, test results, etc.
Psychotherapy Notes: My personal process notes about our sessions, separate from your treatment record
Most uses and disclosures of psychotherapy notes require your written authorization. However, I may use psychotherapy notes without authorization for:
My own training and supervision
Defending myself in legal proceedings you initiate
As required by law (e.g., to prevent serious threat to safety)
2. Marketing
I will not use or disclose your PHI for marketing purposes without your authorization. Educational newsletters or appointment reminders are not considered marketing.
3. Sale of PHI
I will never sell your PHI. This is prohibited by law.
4. Other Uses Requiring Authorization
Any uses or disclosures not described in this Notice will require your written authorization. You may revoke your authorization at any time by providing written notice, except to the extent that action has already been taken in reliance on your authorization.
C. Uses and Disclosures Without Authorization or Opportunity to Object
I may use or disclose your PHI without your authorization in the following situations:
1. Required by Law
When federal, state, or local law requires disclosure of your PHI, I will comply to the extent required.
2. Public Health Activities
I may disclose PHI to public health authorities for activities such as:
Preventing or controlling disease, injury, or disability
Reporting child abuse, elder abuse, or dependent adult abuse
Reporting adverse reactions to medications
Conducting public health surveillance, investigations, or interventions
3. Reporting Abuse, Neglect, or Domestic Violence
California law requires me to report suspected abuse or neglect of:
Children (under 18)
Elders (65 and older)
Dependent adults
I am also required to report domestic violence in certain circumstances. I will inform you when I make such reports unless doing so would place you at risk of harm.
4. Health Oversight Activities
I may disclose PHI to health oversight agencies (such as the California Board of Behavioral Sciences) for:
Audits and investigations
Inspections and licensure activities
Disciplinary proceedings
Civil, administrative, or criminal proceedings
5. Judicial and Administrative Proceedings
I may disclose PHI in response to:
A court order
A subpoena, discovery request, or other lawful process (only after attempting to notify you or obtaining a protective order)
My preference is to obtain your written authorization before releasing records for legal proceedings.
6. Law Enforcement Purposes
I may disclose limited PHI to law enforcement officials for purposes such as:
Complying with a court order, warrant, or subpoena
Identifying or locating a suspect, fugitive, or missing person
Reporting crimes that occur on my premises
Reporting crimes in emergencies
7. Serious Threats to Health or Safety
I may disclose PHI if I believe in good faith that disclosure is necessary to prevent or lessen a serious and imminent threat to:
Your health or safety
The health or safety of another person
The public's health or safety
California's Duty to Warn: Under California law, I have a duty to warn identifiable victims if you communicate a serious threat of physical violence against them.
8. Coroners, Medical Examiners, and Funeral Directors
I may disclose PHI to coroners or medical examiners for the purpose of identifying a deceased person, determining cause of death, or other duties as authorized by law.
9. Research
I may use or disclose PHI for research purposes when:
An Institutional Review Board has approved the research
The research involves only de-identified or aggregated data
You have provided written authorization
10. Workers' Compensation
I may disclose PHI for workers' compensation or similar programs that provide benefits for work-related injuries or illnesses, when authorized by law.
11. Specialized Government Functions
I may disclose PHI for specialized government functions, including:
Military and veterans' activities
National security and intelligence activities
Protective services for the President and others
Correctional institutions and law enforcement custody
12. Appointment Reminders and Treatment Alternatives
I may use and disclose your PHI to:
Contact you to remind you of scheduled appointments
Inform you about treatment alternatives or health-related services that may be of interest to you
D. Disclosures You May Object To
Family and Friends Involved in Your Care
Unless you object, I may disclose relevant PHI to:
A family member, relative, or close personal friend who is involved in your care
Someone you identify as being involved in your care or payment for care
You may object to these disclosures at any time. If you are unable to object (e.g., in an emergency), I will use my professional judgment to determine whether disclosure is in your best interest.
III. Your Rights Regarding Your Health Information
Under federal and California law, you have the following rights regarding your PHI:
A. Right to Inspect and Copy Your PHI
You have the right to inspect and obtain a copy of your PHI contained in your clinical record, including:
Progress notes and treatment plans
Diagnoses and assessment information
Billing and payment records
How to Request: Submit a written request specifying what records you would like to access.
Response Time: I will respond within 30 days of receiving your request (or 60 days if the records are stored off-site).
Fees: I may charge a reasonable, cost-based fee for:
Copying (per page)
Postage (if you request mailing)
Preparation of a summary (if you agree to receive a summary instead of copies)
Exceptions: I may deny your request in certain limited circumstances:
Psychotherapy notes (separate from your treatment record)
Information compiled in anticipation of litigation
When access would likely endanger you or another person
If I deny your request, you have the right to request a review of my decision by another licensed mental health professional.
B. Right to Request Amendments
If you believe that your PHI is incorrect or incomplete, you have the right to request that I amend the information.
How to Request: Submit a written request identifying the information you want changed and explaining why.
Response: I will respond within 60 days. I may:
Accept your request and make the amendment
Deny your request if I determine the information is accurate and complete
If I deny your request, you have the right to submit a written statement of disagreement, which will become part of your record.
C. Right to Request Restrictions
You have the right to request restrictions on how I use or disclose your PHI for treatment, payment, or healthcare operations.
How to Request: Submit a written request specifying the restriction you want and to whom it applies.
My Response: I am not required to agree to your request, except in the following situation:
Required Restriction: If you pay out-of-pocket in full for a service and request that I not disclose PHI about that service to your health plan for payment or healthcare operations purposes, I must agree to your request unless disclosure is required by law.
D. Right to Request Confidential Communications
You have the right to request that I communicate with you about your PHI in a specific way or at a specific location.
Examples:
Calling only your cell phone, not your home or work phone
Sending mail to an alternative address
Communicating only via email
How to Request: Submit a written request specifying how or where you wish to be contacted.
I will accommodate all reasonable requests.
E. Right to an Accounting of Disclosures
You have the right to request an accounting (list) of certain disclosures of your PHI that I have made.
What's Included: The accounting will include:
Date of disclosure
Name of the person or entity who received the information
Brief description of the information disclosed
Purpose of the disclosure
What's NOT Included:
Disclosures for treatment, payment, or healthcare operations
Disclosures made to you or with your authorization
Disclosures for national security purposes
Disclosures made more than 6 years before your request
How to Request: Submit a written request specifying the time period (up to 6 years).
Response Time: I will respond within 60 days.
Fees: The first accounting in any 12-month period is free. I may charge a reasonable fee for subsequent requests.
F. Right to a Paper Copy of This Notice
You have the right to receive a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.
How to Request: Contact me or request a copy during your next appointment.
G. Right to Notification of a Breach
If there is a breach of your unsecured PHI, I am required to notify you in accordance with federal and California law.
IV. Exercising Your Rights
To exercise any of the rights described above, please submit a written request to:
Vineel Maharaj, LMFT #123091
Contact me
Written requests ensure clarity and provide documentation for both of us. I will respond to all requests in a timely manner as required by law.
V. Complaints
If you believe your privacy rights have been violated, you have the right to file a complaint with:
Me:
Vineel Maharaj, LMFT
Contact me
California Board of Behavioral Sciences:
1625 North Market Blvd, Suite S-200
Sacramento, CA 95834
Phone: (916) 574-7830
Website: www.bbs.ca.gov
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
Website: www.hhs.gov/ocr/privacy/hipaa/complaints
You will not be retaliated against for filing a complaint.
VI. Telehealth-Specific Privacy Considerations
Security of Video Sessions
I use HIPAA-compliant, encrypted video conferencing platforms for all online therapy sessions. However, please be aware:
Your Responsibility: You are responsible for ensuring you are in a private location during sessions
Internet Security: No internet transmission is 100% secure; there is always some risk when transmitting information electronically
Technical Issues: If there is a technical failure, we will reconnect or reschedule as needed
Electronic Communications
Email and Text: Email and text are not secure forms of communication. I will use them only for administrative matters (scheduling, brief check-ins). Do not use email or text for emergencies or detailed clinical discussions.
Encrypted Messaging: For secure messaging between sessions, I may offer access to a HIPAA-compliant patient portal.
Data Storage
All electronic records are stored on HIPAA-compliant, encrypted servers with strict access controls.
VII. Changes to This Notice
I reserve the right to change the terms of this Notice. Any changes will apply to all PHI I maintain, including information created or received before the change.
If I make material changes to this Notice:
I will post the updated Notice on my website: www.actualizebeing.com
I will provide you with a copy of the updated Notice
The new Notice will include the effective date
VIII. Questions or More Information
If you have questions about this Notice or would like more information about your privacy rights, please contact me:
Vineel Maharaj, LMFT #123091
Contact me
Website: www.actualizebeing.com
National Provider Number (NPI): 1205280575
Acknowledgment of Receipt
By signing below, you acknowledge that you have received and reviewed this Notice of Privacy Practices.
This acknowledgment will be completed during your intake process.
Professional Credentials:
Vineel Maharaj
Licensed Marriage and Family Therapist
California License #123091
National Provider Number (NPI): 1205280575
This Notice is effective as of the date listed above and complies with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule (45 CFR Part 164) and California privacy laws.