Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL/HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Matt Wagner, LPC is committed to protecting the privacy of your Protected Health Information ("PHI") in accordance with the Health Insurance Portability and Accountability Act (HIPAA).

Our Responsibilities

We are required by law to:

  • Maintain the privacy of your PHI

  • Provide you with this Notice describing our legal duties and privacy practices

  • Notify you if a breach of your unsecured PHI occurs

  • Follow the terms of the Notice currently in effect

How We May Use and Disclose Your Information

We may use or disclose your PHI for the following purposes without your specific authorization:

  • Treatment — to provide, coordinate, or manage your mental health care and related services.

  • Payment — to bill and collect payment for services, including submitting claims to insurance if applicable.

  • Health Care Operations — for internal purposes such as quality assessment, supervision, or administrative functions.

  • As Required by Law — such as reporting suspected abuse/neglect, responding to a court order, or addressing a serious threat to health or safety.

Except as described above, we will not use or disclose your PHI without your written authorization. You may revoke that authorization in writing at any time.

Your Rights

You have the right to:

  • Request restrictions on certain uses and disclosures of your PHI

  • Request confidential communications by an alternative method or location

  • Inspect and obtain a copy of your health records (with limited exceptions)

  • Request an amendment to your health record if you believe it is inaccurate

  • Receive an accounting of certain disclosures of your PHI

  • Obtain a paper copy of this Notice upon request

  • File a complaint if you believe your privacy rights have been violated, without fear of retaliation

How to File a Complaint

You may file a complaint with Matt Wagner, LPC directly, or with the U.S. Department of Health and Human Services, Office for Civil Rights.

Changes to This Notice

We reserve the right to change the terms of this Notice and to make the revised Notice effective for all PHI we maintain. Updated notices will be made available upon request and posted on our website.

Contact Information

If you have questions about this Notice or wish to exercise any of your rights, please contact:

Matt Wagner, LPC
409 Mead Road
Decatur, GA 30030
(770) 285-1720