Notice of Privacy Practices — Thakkar Therapy

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.

Monique Thakkar, MEd, LMHC (MHC.LH.70035164) · Thakkar Therapy · Seattle, WA

Effective date: October 1, 2026

Your health information is personal, and I am committed to protecting it. This notice explains how I may use and share your protected health information (PHI), my legal duties, and your rights. PHI includes your demographic information, mental and physical health history, diagnoses, treatment records, and payment information.

My Duties

I am required by law to:

  • Maintain the privacy and security of your PHI.

  • Give you this notice of my legal duties and privacy practices.

  • Follow the terms of the notice currently in effect.

  • Notify you promptly if a breach occurs that may have compromised the privacy or security of your information.

I will not use or share your information other than as described here unless you give me written permission.

How I Use and Share Your Information

I typically use or share your information in the following ways. I share only the minimum necessary.

  • Treatment: To provide and coordinate your care. Example: With your permission, I may speak with your primary care provider or psychiatrist about your treatment.

  • Payment: To bill and get paid for services. Example: I send your insurer the dates of service and diagnosis needed to process a claim.

  • Health care operations: To run my practice and improve care. Example: I may consult with a colleague about your care without identifying you, or send you appointment reminders.

  • Business associates: I work with vendors, such as my electronic health record, billing, and telehealth platforms, that handle information on my behalf. They are required by contract to protect it.

Other Uses and Disclosures Allowed or Required by Law

I may share your information without your authorization only when the law allows or requires it, including:

  • To prevent serious harm: When I reasonably believe disclosure is necessary to prevent or lessen a serious and imminent threat to your health or safety or someone else's.

  • Abuse or neglect reporting: Suspected abuse or neglect of a child (RCW 26.44) or a vulnerable adult (RCW 74.34).

  • Health oversight: To the Washington State Department of Health or other agencies for audits, investigations, or licensing.

  • Legal proceedings: In response to a court order or a valid subpoena, as permitted by Washington law.

  • Law enforcement: Only when a request meets specific legal requirements.

  • Specialized government functions: Such as national security, when required by law.

  • After death: To a coroner, medical examiner, or your legal personal representative.

Washington protections. Washington law (RCW 70.02) gives mental health information additional protection beyond federal law. Where Washington law is more protective of your privacy, I follow it.

Uses That Require Your Written Authorization

I will ask for your written permission before:

  • Sharing psychotherapy notes (any personal notes I keep separate from your clinical record), except in the limited cases the law allows.

  • Using your information for marketing.

  • Selling your information. I never do this.

  • Any other use or disclosure not described in this notice.

You may revoke an authorization in writing at any time. Revoking it stops future disclosures but does not undo anything already shared while it was in effect.

Your Rights

To use any of these rights, contact me in writing using the information below.

  • See and get a copy of your records. I will respond within 15 working days, as Washington law requires. I may charge a reasonable, cost-based fee. In rare cases I may deny access to part of your record if the law allows; you may ask for that decision to be reviewed.

  • Ask me to correct your records. If you believe something is incorrect or incomplete, you may ask me to amend it. If I decline, I will explain why in writing, and you may submit a statement of disagreement.

  • Get a list of disclosures. You may request a list of times I have shared your information, other than for treatment, payment, operations, or disclosures you authorized. One list per year is free.

  • Ask me to limit what I share. I am not always required to agree. However, if you pay for a service in full out of pocket, I must agree not to share information about that service with your health plan.

  • Request confidential communications. You may ask me to contact you in a specific way, such as only by phone or at a different address. I will accommodate reasonable requests.

  • Get a paper copy of this notice at any time, even if you have received it electronically.

  • Choose someone to act for you. If you have a legal guardian or someone with medical power of attorney, that person may exercise your rights.

Complaints

If you believe your privacy rights have been violated, please talk with me first. You may also file a complaint with:

  • U.S. Department of Health and Human Services, Office for Civil Rights: hhs.gov/ocr/complaints · 1-877-696-6775

  • Washington State Department of Health, Health Systems Quality Assurance Complaint Intake, P.O. Box 47857, Olympia, WA 98504-7857 · 360-236-4700 · HSQAComplaintIntake@doh.wa.gov

I will not retaliate against you in any way for filing a complaint.

Changes to This Notice

I may change this notice, and the changes will apply to all information I hold about you. The current version will always be posted on this website and is available from me on request.

Contact

Privacy and Security Officer: Monique Thakkar, LMHC, MEd, LMHC 360-472-4021 · monique@thakkartherapy.com 5413 North Meridian Ave Seattle WA 98103