Notice of Privacy Practices (HIPAA)

Dixon Marriage and Family Therapy, a California professional corporation, doing business as Morgan Dixon Therapy Morgan Dixon, LMFT · CA License #143871 1492 W. Colorado Blvd, Suite 220, Pasadena, CA 91105 hello@morgan-dixon.com · (626) 532-7124

Effective date: 8/1/2026

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.

Who We Are

This Notice describes the privacy practices of Morgan Dixon Therapy and applies to all protected health information ("PHI") created or received by the practice, including information related to psychotherapy, couples therapy, and ketamine-assisted psychotherapy services.

How We May Use and Disclose Your Health Information

For Treatment. We use your health information to provide you with psychotherapy services and to coordinate your care. Example: with your authorization or as permitted by law, we may communicate with the medical provider who prescribes and manages ketamine as part of your ketamine-assisted psychotherapy care team.

For Payment. We may use and disclose your health information to bill and collect payment for services. Example: if you use out-of-network benefits, we may prepare a superbill containing dates of service, a diagnosis code, and charges for you to submit to your insurer, or share limited billing information with our billing platform.

For Health Care Operations. We may use your health information to run the practice — for example, quality review, clinical consultation and supervision (with identifying details limited or disguised where possible), recordkeeping, and compliance activities.

Note for couples therapy: When treatment is provided to a couple, the treatment record belongs to the treatment unit. Release of couples-therapy records generally requires the authorization of both partners, except as otherwise required or permitted by law.

Uses and Disclosures That Require Your Written Authorization

We will not use or disclose your health information for the following purposes without your written authorization, which you may revoke at any time in writing (except to the extent we have already relied on it):

  • Psychotherapy notes. Most uses and disclosures of psychotherapy notes require your authorization.

  • Marketing. We do not use your information for marketing without your authorization.

  • Sale of information. We will never sell your health information.

Uses and Disclosures That Do Not Require Your Authorization

State and federal law permit or require disclosure without your authorization in limited situations, including:

  • When required by law, including reporting requirements applicable to California licensed therapists.

  • Suspected abuse or neglect. As a mandated reporter, your therapist must report known or reasonably suspected abuse or neglect of a child, elder, or dependent adult.

  • Serious threat of harm. If you communicate a serious threat of physical violence against an identifiable person, or if disclosure is necessary to prevent a serious and imminent threat to your health or safety or that of another, we may notify appropriate persons, including potential victims and law enforcement, as required or permitted by law.

  • Danger to self. If there is reason to believe you are at serious risk of harming yourself, we may take protective steps permitted by law, which may include contacting emergency services or persons who can help provide protection.

  • Judicial and administrative proceedings, such as a valid court order. If we receive a subpoena, we will take steps required by law before releasing information, and psychotherapist–patient privilege may apply.

  • Health oversight activities, such as audits or investigations by the California Board of Behavioral Sciences or other agencies authorized by law.

  • Public health activities as authorized by law.

  • Coroners and medical examiners as authorized by law.

  • Workers' compensation proceedings, to the extent authorized by law.

  • Specialized government functions as authorized by law.

Where California law provides you greater privacy protection than federal law, we follow California law.

Your Rights Regarding Your Health Information

  • Right to inspect and copy. You may request access to your clinical record, with limited exceptions provided under California law. We may charge a reasonable, cost-based fee for copies. In some circumstances California law permits a treatment summary in place of the full record.

  • Right to amend. If you believe information in your record is incorrect or incomplete, you may request an amendment in writing. We may deny the request in certain circumstances, and you have the right to submit a written addendum to your record.

  • Right to an accounting of disclosures. You may request a list of certain disclosures of your health information made in the six years prior to your request.

  • Right to request restrictions. You may request restrictions on how we use or disclose your information. We are not required to agree to all requests, but we must agree to restrict disclosure to your health plan if the disclosure is for payment or operations and you (or someone on your behalf) paid for the service in full out of pocket.

  • Right to confidential communications. You may ask us to contact you in a specific way or at a specific location (for example, only by email, or only at a particular phone number), and we will accommodate reasonable requests.

  • Right to a paper copy of this Notice. You may request a paper copy at any time, even if you agreed to receive it electronically.

  • Right to breach notification. We will notify you as required by law if a breach occurs that compromises the privacy or security of your unsecured health information.

To exercise any of these rights, contact us in writing at hello@morgan-dixon.com or the address above.

My Duties

I am required by law to maintain the privacy and security of your protected health information, to provide you with this notice of our legal duties and privacy practices, and to abide by the terms of the notice currently in effect. I reserve the right to change this notice and to make the revised notice effective for information we already hold. The current notice will be posted on my website and available in the office, and material revisions will be made available to current clients.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us using the contact information above, or with the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue S.W., Washington, D.C. 20201, 1-877-696-6775, or online at www.hhs.gov/ocr/complaints. We will not retaliate against you for filing a complaint.

Contact

Privacy questions and requests: Morgan Dixon, LMFT — hello@morgan-dixon.com — (626) 532-7124.