OUR PRIVACY POLICY

Learn more about your privacy and your rights. 

Petersen Family Counseling understands the necessity of protecting the  privacy of your data when you visit our website. The following outlines how we  protect your personal information collected with your visit to our site. Petersen  Family Counseling may update our statement on occasion as new programs,  services, and processes are implemented. 

Petersen Family Counseling does not collect information, including email  addresses, from you without asking first. In some instances, we may request  you to supply information personally, which could include contact information  like your email, street address, phone number or other information. This  serves to personalize your visit to our site to make it more beneficial for you. It  is completely voluntary for you to provide this information, but when you do,  we make the assumption you have agreed to our use of that data in  accordance with this privacy policy. 

Petersen Family Counseling does not intentionally use, collect, or disclose  patient information on its website that is personally identifiable. You should not  post information on our website that could be used to identify you. If we  discover we have personal information, we will begin the process to delete the  date as quickly as possible. 

You must be at least 18 years old to receive permission from us to use our  website. We will not intentionally or knowingly collect personally identifiable  information about visitors under the age of 18. 

WHEN INFORMATION IS PROVIDED 

When you share information with us voluntarily, that is implied consent for the collection and use of your data by our practice. Petersen Family Counseling will not rent or sell personal data we collect on this website to anyone. 

Petersen Family Counseling may offer the option to register or purchase  products online. During the transaction, it is possible that personal information  will be collected. If that is the case, we may share that information with other  parties to accommodate support services like credit card authorization or 

fulfillment of your order. By voluntarily giving us that information, you give  Petersen Family Counseling permission to provide your data to the third  parties that provide these services. You also agree not to hold Petersen  Family Counseling responsible for any of the actions or omissions of these  third parties. 

Petersen Family Counseling may also collect non-personal information  provided by your browser when you request a page view from your server.  This information may include your browser time, IP address, and access  times. Petersen Family Counseling uses this information for supporting  website operations and to evaluate traffic patterns for our website. 

Some of the statistics Petersen Family Counseling may collect and use  includes volume, traffic patterns, referral sources, login activity and other  information related to our website to support our operations. The information  may be shared with third parties, but will not include personally identifiable  data of any kind. Petersen Family Counseling may disclose information in  special cases where required, such as: 

  1. Follow legal requirements; 
  2. Defend or protect our property and rights: 
  3. Enforce our Terms and Conditions of Use; 
  4. Protect our users’ interests. 

Occasionally, Petersen Family Counseling may be required by law  enforcement or the legal system to provide personal information to the  appropriate authorities. This information will be disclosed with a court order,  subpoena or to otherwise cooperate with an investigation conducted by law  enforcement. Petersen Family Counseling reserves the right to report  activities we believe to be unlawful to the proper authorities or law  enforcement agencies. 

Petersen Family Counseling reserves the right to send mail or email regarding  products or services to the personal information you have voluntarily provided.  If you do not wish to receive these communications, we will provide  instructions to easily indicate that desire as well. 

USE OF COOKIES 

Choice House may use Internet technology known as “cookies” to identify  your device so we can offer appropriate website features to you that are  compatible with that device. Cookies also provide us information about  whether you have visited our website in the past. They do not allow us to 

collect your email address or other information from your hard drive. Petersen  Family Counseling may use memory-based cookies to authenticate some of  our website applications. The control of your browser settings remains with  you, as you can choose to accept all cookies, reject all cookies, or receive  notifications when a cookie is sent. If you set your browser to reject cookies,  you may not be able to use all the features of our website that require them. 

Petersen Family Counseling reserves the right to utilize Google products like  Google Display Network Impression Reporting, Remarketing with Google  Analytics, Google Analytics Demographics, DoubleClick Campaign Manager,  or Interest Reporting. You may choose to opt-out of Google Analytics for  Display Advertising and customize Google Display Network ads using  Google’s Ads Settings. You can also utilize the Google Analytics Opt-Out  Browser Add On if you choose to prevent having your data used by Google  Analytics. 

Petersen Family Counseling will not initiate the merging of your personal  information with non-personal data collected from Display Advertising features  based on the DoubleClick cookie unless we give you clear notice and you  provide your consent for such action. 

Petersen Family Counseling may use Remarketing with Google Analytics for online advertising. In addition, third-party vendors may insert ads for our  practice on different sites on the Internet. This does include Google. Both  Petersen Family Counseling and third-party vendors may also use first-party  cookies (including the Google Analytics cookie) and other third-party cookies  (including the DoubleClick cookie) alone or in combination to optimize, inform  and serve ads based on your previous visits to our website. 

Petersen Family Counseling and third parties, including Google, may also use  both first-party and third-party cookies, alone or in combination, to determine  how ad impressions, other uses of ad services and interactions with these  services are related to our website visits. Petersen Family Counseling may  also use information from Google’s Interest-based advertising or data from its  third-party audience, which might include age, gender, and interests. The date  will be combined with Google Analytics to provide general profiles about  visitors and determine how visitors might use the site. This information can  then be used to improve the content, marketing, and design of the website, as  well as services and products offered here. 

Petersen Family Counseling may use the Facebook.com “conversion tracking  pixel” to determine whether Facebook’s advertisements are effective for  marketing purposes. This tool allows us to gather information on users’  actions after the user is directed to a third-party website through a click on a Facebook ad on this website. The data we collect with this tool does not  include personally-identifying information. However, Facebook may use this  information according to Facebook’s Data Policy to show you advertisements  on both Facebook.com and third-party websites that might be of interest to  you. A cookie may be used to facilitate advertisement displays by both  Facebook and its partners. 

Petersen Family Counseling may also use Twitter.com products tailoring  audiences and conversion tracking. The products connect data from Twitter’s  advertising network to your own actions performed on the website. To learn  more about the type of information collected, refer to Twitter’s Privacy Policy. 

LINKS TO ADDITIONAL WEBSITES 

Petersen Family Counseling’s website contains links to other sites. While we  try to only link to sites that share a high respect for privacy, Petersen Family  Counseling is not responsible for privacy policies held by other websites. If  you have questions about this statement, you should contact us. 

OUR RELATIONSHIP 

Petersen Family Counseling understands the importance of a Patient’s  relationship with his or her health care providers and the importance of  keeping your Personal Information private. Personal information identifies you  as an individual, such as your name, postal address, email address, date of  birth, and telephone number (“Personal Information”). 

Health Information is a part of the Personal Information that we collect from  Patients. Health Information is generally described as information that we  collect, receive or create about a Patient and their healthcare. 

As an example, we may collect Personal Information about Authorized  Personnel or an Authorized Caregiver who uses the Services to help a  Patient. And we may collect information about a Patient that is unrelated to  their healthcare, such as basic registration, creating a profile, and information  from third parties that is included within a Patient’s profile. 

This Privacy Policy describes our practices in connection with information that  we collect through your use of the Services and through the Site or  Applications. You can visit the Site at any time without providing Personal  Information, however, the Site may collect information about your visit  automatically as described below “Information We Collect Automatically.” By 

using the Services and/or the Site, you agree to the terms and conditions of  this Privacy Policy. 

 

WHAT PERSONAL INFORMATION DO  WE COLLECT ABOUT YOU AND WHY? 

Personal Information We Collect From Providers 

If you are an Authorized Personnel user, we collect Personal Information  about you when the Provider subscribes to the Services as well as when you  register to use the Services. The Personal Information about Providers and  Authorized Personnel that we collect includes, without limitation, the  Provider’s and Authorized Personnel’s name, position, specialty, email  address, phone number, and business postal address. We do not collect  Health Information about Providers or their Authorized Personnel. 

Personal Information We Collect From Patients  and Authorized Caregivers 

If you are a Patient, we collect Personal Information about you when you  register to use the Services and through your or your Authorized Caregiver’s  use of the Services, including when you, your Authorized Caregiver, and your  Provider communicate with each other. 

If you are an Authorized Caregiver, we collect Personal Information about you,  including, without limitation, your name, email address, phone number, and  your relationship to the Patient. When communicating with the Provider in  using the Services, the Patient, Authorized Caregivers, Provider, and its  Authorized Personnel may disclose Personal Information about the Patient,  which may include Health Information. We do not collect Health Information  about Authorized Caregivers. 

To register to use the Services as a Patient, you must provide your name,  primary address, email address, and date of birth. If a Patient or Authorized  Caregiver uses the “Link Online Accounts” feature of the Services, we will ask  you to provide the user names and passwords for those online accounts that  the Patient has authorized Petersen Family Counseling to access in order to  collect other Personal Information regarding the Patient and Patient’s medical  history that is maintained by third parties Patient has identified in Patient’s  Account as “Authorized Third Parties.” The Personal Information the Patient  may permit us to obtain from these Authorized Third Parties may include, 

without limitation, demographic information, financial information, medical  claims history, and other Health Information. 

We also may collect additional optional information from you, including, for  example, Social Security number, employment history, health care insurance  information, and demographic data, however, you are not required to provide  us with this information to use the Services. 

 

HOW WE USE YOUR PERSONAL  INFORMATION 

We may use your Personal Information, as  follows: 

To provide our Services to you, to communicate with you about your use of  our Services, to respond to your inquiries, and for other customer service  purposes. 

To tailor the educational and other content and information that we may send  you, to offer personalized help and instructions, and to otherwise personalize  your experiences while using the Site, Applications, or our Services. To better understand how users access and use our Site, Applications, and  Services, both on an aggregated and individualized basis, in order to improve  our Site, Applications, and Services and respond to user desires and  preferences, and for other research and analytical purposes. To send you important information regarding the Services, changes to our  terms, conditions, and policies, and/or other administrative information. For our business purposes, such as data collection and analysis, audits,  developing new products, and enhancing and improving our Site,  Applications, and Services. 

As we believe to be necessary or appropriate: (a) under applicable law,  including laws outside your state or country of residence; (b) to comply with  legal process; (c) to respond to requests from public and government  authorities including public and government authorities outside your state or  country of residence; (d) to enforce our terms and conditions; (e) to protect  our operations or those of any of our affiliates; (f) to protect our rights, privacy,  safety or property, and/or that of our affiliates, you or others; and (g) to allow  us to pursue available remedies or limit the damages that we may sustain.

 

HOW WE SHARE YOUR PERSONAL  INFORMATION 

We may disclose your Personal Information,  including Health Information (defined below) as  follows: 

If you are a Patient, to your Provider, its Authorized Personnel and your  Authorized Caregivers, without further authorization for purposes of treatment,  payment or operations; for other uses or disclosures permitted by law; or for  purposes related to such uses or disclosures. 

If you are an Authorized Caregiver, to the Patient and his/her Provider and  that Provider’s Authorized Personnel. 

To our third-party service providers who provide services such as website  hosting, data gathering, data analysis, payment processing, infrastructure  provision, IT services, customer service, email delivery services, credit card  processing, backup, auditing services, and other similar services. 

To a third party in the event of any reorganization, merger, sale, joint venture,  assignment, transfer or other disposition of all or any portion of our business,  assets or stock (including in connection with any bankruptcy or similar  proceedings). 

As we believe to be necessary or appropriate: (a) under applicable law,  including laws outside your state or country of residence; (b) to comply with  legal process; (c) to respond to requests from public and government  authorities including public and government authorities outside your state or  country of residence; (d) to enforce our terms and conditions; (e) to protect  our operations or those of any of our affiliates; (f) to protect our rights, privacy,  safety or property, and/or that of our affiliates, you or others; and (g) to allow  us to pursue available remedies or limit the damages that we may sustain. 

To third parties for research or similar purposes, but only if such Personal  Information has been de-identified. 

 

WHAT IS HEALTH INFORMATION?

Health Information is a part of the Personal  Information that we collect about Patients and  falls into two categories: 

“Protected Health Information” is individually identifiable health information  which is created or received by or on behalf of a covered entity (for example,  a health care provider or health plan) and which relates to the past, present or  future physical or mental health or condition of an individual, the provision of  health care to an individual, or the past, present or future payment for the  provision of health care to an individual. Protected Health Information is  further defined by the federal Health Insurance Portability and Accountability  Act of 1996 (HIPAA) and is subject to the protections of HIPAA. “Additional Health Information” is a subset of Health Information that does not  fall within the category of Protected Health Information above. For example,  this would encompass information related to past, present or future physical or  mental health or conditions, the provision of health care to an individual, or the  past, present or future payment for the provision of health care to an individual  but with the difference that such information was not created or received by us  from or on behalf of a covered entity. We may collect Additional Health  Information in connection with the Site or Applications. 

 

HOW WE USE AND/OR SHARE  PROTECTED HEALTH INFORMATION  AND ADDITIONAL HEALTH INFORMATION 

We may use and/or disclose Protected Health Information and Additional  Health Information to provide the Services as described in this policy, except  our use and disclosure of Protected Health Information is further limited by the  main federal health privacy law known as the Health Insurance Portability and  Accountability Act of 1996 (“HIPAA”) and the Notice of Privacy Practices  available from your Provider. 

We will use and disclose Protected Health Information only to provide  Services to the Patient or the Provider, for those uses and disclosures  permitted by HIPAA, and the agreement that we have with your Provider. In  the event that there is a conflict or inconsistency about the handling of  Protected Health Information between (i) this Privacy Policy and (ii) our 

compliance obligations with HIPAA and contractual commitments with  Providers, then the latter will govern. 

NON-PERSONAL INFORMATION WE  COLLECT AUTOMATICALLY 

We may automatically collect the following information about your use of our  Site or Services through cookies, web beacons, and other technologies: your  domain name; your browser type and operating system; web pages you view;  links you click; your IP address; the length of time you visit our Site or use our  Services; and the referring URL, or the webpage that led you to our Site, and  the following: access time, browser type, device ID, domain name, IP address,  page views and referring URL. We also may collect the following information  about your use of the Application: mobile device ID; location and language  information; device name and model; operating system type, name, and  version; your activities within the Application; and the length of time that you  are logged into our Application. We may combine this information with other  information that we have collected about you, including, where applicable,  your user name, name, and other personal information. Please see the  section “Our Use of Cookies and Other Tracking Mechanisms” below for more  information. 

 

OUR USE OF COOKIES AND OTHER  TRACKING MECHANISMS 

We and our third-party service providers use cookies and other tracking  mechanisms to track information about your use of our Site or Services. We  may combine this information with other personal information we collect from  you (and our third-party service providers may do so on our behalf). 

Currently, our systems do not recognize browser “do-not-track” requests. You  may, however, disable certain tracking as discussed in this section (e.g., by  disabling cookies); you also may opt-out of targeted advertising by following  the instructions in the Third Party Ad Network section. 

Cookies:

Cookies are alphanumeric identifiers that we transfer to your  computer’s hard drive through your web browser for record-keeping purposes.  Some cookies allow us to make it easier for you to navigate our Site and  Services, while others are used to enable a faster log-in process or to allow us  to track your activities at our Site and Service. There are two types of cookies:  session and persistent cookies.

Session Cookies:

Session cookies exist only during an online session. They  disappear from your computer when you close your browser or turn off your  computer. We use session cookies to allow our systems to uniquely identify  you during a session or while you are logged into the Site. This allows us to  process your online transactions and requests and verify your identity after  

you have logged in, as you move through our Site. 

Persistent Cookies:

Persistent cookies remain on your computer after you  have closed your browser or turned off your computer. We do not currently  use persistent cookies on the Site. 

Disabling Cookies:

Most web browsers automatically accept cookies, but if  you prefer, you can edit your browser options to block them in the future. The  Help portion of the toolbar on most browsers will tell you how to prevent your  computer from accepting new cookies, how to have the browser notify you  when you receive a new cookie, or how to disable cookies altogether. Visitors  to our Site who disable cookies will be able to browse certain areas of the  Site, but some features may not function. 

Local Storage Objects:

We may use Flash Local Storage Objects (“Flash  LSOs”) to store your Site preferences and to personalize your visit. Flash  LSOs are different from browser cookies because of the amount and type of  data stored. Typically, you cannot control, delete, or disable the acceptance of  Flash LSOs through your web browser. For more information on Flash LSOs,  or to learn how to manage your settings for Flash LSOs, go to the Adobe  Flash Player Help Page, choose “Global Storage Settings Panel” and follow  the instructions. To see the Flash LSOs currently on your computer, choose  “Website Storage Settings Panel” and follow the instructions to review and, if  you choose, to delete any specific Flash LSO. 

Third-Party Analytics:

We use automated devices and applications, such as  Google Analytics, to evaluate usage of our Site and, to the extent permitted,  our Applications. We also may use other analytic means to evaluate our  Services. We use these tools to help us improve our Services, performance  and user experiences. These entities may use cookies and other tracking  technologies to perform their services. We do not share your personal  information with these third parties. 

With respect to Google Analytics specifically, we may collect the some or all of  the following information about your use of our Site and Applications, and we  may be able to connect this information to other information we have about  you:

  •  Pages visited, time of visit, and time spent on 

each page of the webpages 

  •  Type of web browser 
  •  Type of operating system (OS) 
  •  Screen resolution 
  •  IP address 
  •  Third-Party Links 

Our Site and Services may contain links to third-party websites. Any access to  and use of such linked websites is not governed by this Policy but instead is  governed by the privacy policies of those third-party websites. We are not  responsible for the information practices of such third party websites. 

 

SECURITY OF PERSONAL INFORMATION 

We use reasonable administrative, technical, and physical measures to  protect Personal Information under our control, and Protected Health  Information is specifically per the HIPAA rules. Unfortunately, no data  transmission over the Internet or data storage system can be guaranteed to  be 100% secure. If you have reason to believe that your interaction with us is  no longer secure (for example, if you feel that the security of any account you  might have with us has been compromised), please immediately notify us of  the problem by contacting us. 

You should take steps to protect against unauthorized access to your  password, phone, and computer by, among other things, signing off after  using a shared computer, choosing a robust password that nobody else  knows or can easily guess, and keeping your log-in and password private. We  are not responsible for any lost, stolen, or compromised passwords or for any  activity on your account via unauthorized password activity. 

 

ACCESS TO MY PERSONAL INFORMATION 

You may modify Personal Information that you have submitted by logging into  your account and updating your profile information. Please note that copies of  information that you have updated, modified or deleted may remain viewable  in cached and archived pages of the Site or Application for a period of time.

You may also contact us directly if you would like to review, correct, update,  delete or otherwise limit our use of your Personal Information that has been  previously provided to us by sending us a message through  https://www.ourwebsiteURL.com/contact/. In your request, please make clear  what information you would like to have changed, whether you would like to  have your Personal Information deleted from our database or otherwise let us  know what limitations you would like to put on our use of your Personal  Information. We will try to comply with your request as soon as reasonably  practicable. Please note that in order to comply with certain requests to limit  use of your Personal Information we may need to terminate your account with  us and your ability to access and use the Services, and you agree that we will  not be liable to you for such termination. Although we will use reasonable  efforts to do so, you understand that it may not be technologically possible to  remove from our systems every record of your Personal Information. The  need to back up our systems to protect information from inadvertent loss  means a copy of your Personal Information may exist in a non-erasable form  that will be difficult or impossible for us to locate or remove. 

We will retain your Personal Information for the period necessary to fulfill the  purposes outlined in this Privacy Policy unless a longer retention period is  required or allowed by law. 

 

WHAT CHOICES DO I HAVE REGARDING USE OF MY PERSONAL  INFORMATION? 

We may send periodic promotional or informational emails to you, provided  that such messages are not based on Protected Health Information. You may  opt-out of such communications by following the opt-out instructions contained  in the e-mail. Please note that it may take up to 10 business days for us to  process opt-out requests. If you opt-out of receiving emails about  recommendations or other information we think may interest you, we may still  send you e-mails about your account or any Services you have requested or  received from us. 

 

CHILDREN UNDER 18 

The Services are not permitted for use by individuals under the age of  eighteen (18) unless they have provided the written consent of their parents or 

legal guardians, and we request that these individuals do not provide Personal  Information to us. 

 

SPECIAL INFORMATION FOR CALIFORNIA CONSUMERS 

California residents may request a list of certain third parties to which we have  disclosed personally identifiable information about you for their own direct  marketing purposes. You may make one request per calendar year. In your  request, please attest to the fact that you are a California resident and provide  a current California address for your response. You may request this  information in writing by contacting us. Please allow up to thirty (30) days  for a response. 

 

PERSONAL HEALTH INFORMATION 

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 

 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 a copy of your health and claims records 

You can ask to see or get a copy of your health and claims records 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 and claims records,  usually within 30 days of your request. We may charge a reasonable, cost based fee. 

Ask us to correct health and claims records 

You can ask us to correct your health and claims records if you think they are  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 consider all reasonable requests, and must say “yes” if you tell us you  would be in danger if we do not. 

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. 

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 this page. 

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  visitingwww.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  payment for your care 

Share information in a disaster relief situation 

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 

 

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: 

Help manage the health care treatment you  receive:

We can use your health information and share it with professionals who are  treating you. Example: A doctor sends us information about your diagnosis  and treatment plan so we can arrange additional services. 

Run our organization: 

We can use and disclose your information to run our organization and contact  you when necessary. We are not allowed to use genetic information to decide  whether we will give you coverage and the price of that coverage. This does  not apply to long term care plans. Example: We use health information about  you to develop better services for you. 

Pay for your health services: 

We can use and disclose your health information as we pay for your health  services. Example: We share information about you with your dental plan to  coordinate payment for your dental work. 

Administer your plan: 

We may disclose your health information to your health plan sponsor for plan  administration. Example: Your company contracts with us to provide a health  plan, and we provide your company with certain statistics to explain the  premiums we charge. 

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. 

Respond to organ and tissue donation requests and work with a medical  examiner or funeral director: 

  •  We can share health information about you 

with organ procurement organizations. 

  •  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. 

For more information see:  

www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html. Changes to the Terms of This Notice 

We can change the terms of this notice, and the changes will apply to all  information we have about you. The new notice will be available upon request,  on our website, and we will mail a copy to you. Our ResponsibilitiesThis  Notice of Privacy Practices applies to the following organizations. 

 

CONTACTING

Petersen Family Counseling 

If you have questions about the privacy aspects of our Services or would like  to make a complaint about our compliance with this Privacy Policy, you may  contact us by calling 720-541-6289.

B E G I N    Y O U R    J O U R N E Y   

T O W A R D

RECOVERY

*By submitting this form via this web portal, you acknowledge and accept that risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking “Yes, I want to submit this form” you agree to hold this business and its associates harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.

HEAL. GROW. THRIVE.

We help families and individuals solve problems and address challenges. With offices in Denver and Jacksonville, and telehealth options, The Chronic Hope Institute helps family systems across the country heal from within.

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