Relationships, Couples, Depression, Anxiety and
Worry, Career Counseling, Self-Esteem, Adolescents,
Transitions, Spiritual Wellness, Burnout, Grief and
Loss, Emotional Balance, Substance Abuse, Parenting
Training, Family Issues, Crisis Intervention,
Trauma and abuse, Assessment
Video Chat sessions take place on through the
client portal, or by using Vsee. If you use
Vsee, do not email me using my email address
connected to Vsee. Upon registering on the
client portal you will see your appointment time.
To attend the appointment simply use a device
with a camera, microphone, speakers, and screen.
If using video conferencing on the client
portal simply click on your appointment and then
click on "start session". If you use Vsee,
you will recieve an email invitation to Vsee from
me, and you will have to download Vsee to your
device.
Phone sessions simply take place by you calling Ray
at 585-577-7575 at your appointment time.
Email sessions take place on the client portal.
Upon registering on the client portal, and
speaking to Ray about your email sessions, you will
be able to secure message "email" Ray. Ray
will respond to your emails within 24 hours time,
excluding weekends and holidays.
Technology issues are not expected. However,
if you do encounter technology issues when trying
to attend your session you can call Ray at
585-857-6122 or use this link as an alternative way
to video chat with Ray.
All communication between you and Ray is designed
to either take place via a phone call, or
by using strong encryption. All records are
also kept using strong encryption and security
procedures. Please to not text Ray using
standard SMS texting since it is not secure.
Your Information. Your Rights. Our
Responsibilities.
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.
Your Rights
You have the right to:
- Get a copy of your paper or electronic medical
record
- Correct your paper or electronic medical record
- Request confidential communication
- Ask us to limit the information we share
- Get a list of those with whom we've shared your
information
- Get a copy of this privacy notice
- Choose someone to act for you
- File a complaint if you believe your privacy
rights have been violated
Your Choices
You have some choices in the way that we use and
share information as we:
- Tell family and friends about your condition
- Provide disaster relief
- Include you in a hospital directory
- Provide mental health care
- Market our services and sell your information
- Raise funds
Our Uses and Disclosures
We may use and share your information as
we:
- Treat you
- Run our organization
- Bill for your services
- Help with public health and safety issues
- Do research
- Comply with the law
- Respond to organ and tissue donation requests
- Work with a medical examiner or funeral
director
- Address workers' compensation, law enforcement,
and other government requests
- Respond to lawsuits and legal actions
Your Rights
When it comes to your health information, you
have certain rights. This section explains your
rights and some of our responsibilities to help
you.
Get an electronic or paper copy of your medical
record
- You can ask to see or get an electronic or
paper copy of your medical record and other
health information we have about you. Ask us how
to do this.
- We will provide a copy or a summary of your
health information, usually within 30 days of
your request. We may charge a reasonable,
cost-based fee.
Ask us to correct your medical record
- You can ask us to correct health information
about you that you think is incorrect or
incomplete. Ask us how to do this.
- We may say "no" to your request, but we'll tell
you why in writing within 60 days.
Request confidential communications
- You can ask us to contact you in a specific way
(for example, home or office phone) or to send
mail to a different address.
- We will say "yes" to all reasonable requests.
Ask us to limit what we use or share
- You can ask us not to use or share certain
health information for treatment, payment, or our
operations. We are not required to agree to your
request, and we may say "no" if it would affect
your care.
- If you pay for a service or health care item
out-of-pocket in full, you can ask us not to
share that information for the purpose of payment
or our operations with your health insurer. We
will say "yes" unless a law requires us to share
that information.
Get a list of those with whom we've shared
information
- You can ask for a list (accounting) of the
times we've shared your health information for
six years prior to the date you ask, who we
shared it with, and why.
- We will include all the disclosures except for
those about treatment, payment, and health care
operations, and certain other disclosures (such
as any you asked us to make). We'll provide one
accounting a year for free but will charge a
reasonable, cost-based fee if you ask for another
one within 12 months.
Get a copy of this privacy notice
You can ask for a paper copy of this notice at
any time, even if you have agreed to receive the
notice electronically. We will provide you with a
paper copy promptly.
Choose someone to act for you
- If you have given someone medical power of
attorney or if someone is your legal guardian,
that person can exercise your rights and make
choices about your health information.
- We will make sure the person has this authority
and can act for you before we take any action.
File a complaint if you feel your rights are
violated
- You can complain if you feel we have violated
your rights by contacting us using the
information on page 1.
- You can 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/.
- We will not retaliate against you for filing a
complaint.
Your Choices
For certain health information, you can tell us
your choices about what we share. If you have a
clear preference for how we share your
information in the situations described below,
talk to us. Tell us what you want us to do, and
we will follow your instructions.
In these cases, you have both the right and
choice to tell us to:
- Share information with your family, close
friends, or others involved in your care
- Share information in a disaster relief
situation
- Include your information in a hospital
directory
If you are not able to tell us your preference,
for example if you are unconscious, we may go
ahead and share your information if we believe it
is in your best interest. We may also share your
information when needed to lessen a serious and
imminent threat to health or safety.
In these cases we never share your information
unless you give us written permission:
- Marketing purposes
- Sale of your information
- Most sharing of psychotherapy notes
In the case of fundraising:
- We may contact you for fundraising efforts, but
you can tell us not to contact you again.
Our Uses and Disclosures
How do we typically use or share your health
information?
We typically use or share your health information
in the following ways.
Treat you
We can use your health information and share it
with other professionals who are treating you.
Example: A doctor treating you for an injury asks
another doctor about your overall health
condition.
Run our organization
We can use and share your health information to
run our practice, improve your care, and contact
you when necessary.
Example: We use health information about you to
manage your treatment and services.
Bill for your services
We can use and share your health information to
bill and get payment from health plans or other
entities.
Example: We give information about you to your
health insurance plan so it will pay for your
services.
How else can we use or share your health
information?
We are allowed or required to share your
information in other ways - usually in ways that
contribute to the public good, such as public
health and research. We have to meet many
conditions in the law before we can share your
information for these purposes.
For more information see:
www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues
We can share health information about you for
certain situations such as:
- Preventing disease
- Helping with product recalls
- Reporting adverse reactions to medications
- Reporting suspected abuse, neglect, or domestic
violence
- Preventing or reducing a serious threat to
anyone's health or safety
Do research: We can use or
share your information for health research.
Comply with the law
We will share information about you if state or
federal laws require it, including with the
Department of Health and Human Services if it
wants to see that we're complying with federal
privacy law.
Information will be shared in the following
cases:
- An indication of child abuse or neglect is
occurring or has occurred.
- An indication that abuse or neglect of an
incapacitated adult is occurring or occurred.
- If you threaten to harm yourself.
- If you threaten to harm another person.
- If you gravely disabled and unable to care for
yourself.
- The disclosure of a previously unreported
felony crime that was committed.
- To assist relevant authorized personnel
(doctors, nurses, etc.) in the event of a medical
emergency.
- To report the misconduct of other
professionals.
Respond to organ and tissue donation requests
We can share health information about you with
organ procurement organizations.
Work with a medical examiner or funeral director
We can share health information with a coroner,
medical examiner, or funeral director when an
individual dies.
Address workers' compensation, law enforcement,
and other government requests
We can use or share health information about you:
- For workers' compensation claims
- For law enforcement purposes or with a law
enforcement official
- With health oversight agencies for activities
authorized by law
- For special government functions such as
military, national security, and presidential
protective services
Respond to lawsuits and legal actions
We can share health information about you in
response to a court or administrative order, or
in response to a subpoena.
Our Responsibilities
- We are required by law to maintain the privacy
and security of your protected health
information.
- We will let you know promptly if a breach
occurs that may have compromised the privacy or
security of your information.
- We must follow the duties and privacy practices
described in this notice and give you a copy of
it.
- We will not use or share your information other
than as described here unless you tell us we can
in writing. If you tell us we can, you may change
your mind at any time. Let us know in writing if
you change your mind.
Our Compliance Officer is available for any
questions and to respond to any requests:
Raymond Barrett 585-577-7575
10/26/21