Jean-Marie Roddy, LCPC, LLC Privacy Practices

9041 Naygall Road, Parkville, MD 21234

jeanmarieroddylcpc@gmail.com, 410-656-9416

This notice went into effect on 2/16/2026

 

Your Information. Your Rights. MyResponsibilities.

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 me to limit the information I share

• Get a list of those with whom I’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 I use and share information as I: 

• Treat you

• Run my organization

• Bill for your services

• Fulfill your requests to share information with your consent

• Tell family and friends about your condition

• Provide disaster relief

• Provide mental health care

• Market my services

• Prevent multiple program enrollments 

• Report about court-referred treatment

• Report to prescription drug monitoring programs

Our Uses and Disclosures

I may use and share your information as I: 

• Help with public health and safety issues

• Help with medical emergencies

• Aid scientific research

• Comply with the law

• Respond to organ and tissue donation requests

• Work with a medical examiner or funeral director

• Assist cause of death inquiries

• Address workers’ compensation, law enforcement, and other government requests

• Respond to lawsuits and legal actions

• Report crimes (and threats of crimes) on my premises and suspected child abuse and neglect

• Respond to audits and evaluations of my program

•  Respond to court orders

 

In all these circumstances, I must protect your information and limit how I use and share it.

 

To the extent that I have your substance use disorder patient records, subject to 42 CFR part 2, I will not share that information for investigations or legal proceedings against you without (1) your written consent or (2) a court order and a subpoena.

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.

Provide consent when I use or share your information for most purposes

• You may provide a single consent for all future uses or disclosures for treatment, payment, and health care operations purposes.

• You may provide consent for more limited purposes (for example, to only disclose information to another health care provider for your treatment); however, doing so may affect the services I can provide you or how you pay for services.

• You may provide a general consent to share your information through certain third parties, such as a health information network or a research institution, where your treating health care providers can access it.

 

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 I have about you. Ask me how to do this. 

• I will provide a copy or a summary of your health information, usually within 30 days of your request. I may charge a reasonable, cost-based fee.

Ask me to correct your medical record

• You can ask me to correct health information about you that you think is incorrect or incomplete. Ask Me how to do this.

• I may say “no” to your request, but I’ll tell you why in writing within 60 days.

Request confidential communications

• You can ask me to contact you in a specific way (for example, home, office, or cell phone) or to send mail to a different address. 

• I will say “yes” to all reasonable requests.

Ask me to limit what I use or share

• You can ask me not to use or share certain health information for treatment, payment, or my operations. I am not required to agree to your request, and I may say “no,” for example, if it could affect your care. If I agree to your request, I may still share this information in the event that you need emergency treatment.

• If you pay for a service or health care item out-of-pocket in full, you can ask me not to share that information for the purpose of payment or our operations with your health insurer. I will say “yes” unless a law requires me to share that information.

Get a list of those with whom I’ve shared information

• You can ask for a list (accounting) of the times I’ve shared your health information for six years prior to the date you ask, who I shared it with, and why.

• I will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked me to make). I’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. I will provide you with a paper copy promptly.

Choose someone to act for you

• If someone has authority to act as your personal representative, such as if someone has your medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

• I will make sure the person has this authority and can act for you before I take any action.

 

File a complaint if you feel your rights are violated

• You can complain if you feel I have violated your rights by contacting me 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 https://www.hhs.gov/hipaa/filing-a-complaint/index.html.

• I will not retaliate against you for filing a complaint.

 

Your Choices

How do I typically use or share your health information?

With your consent, I typically use or share your health information in the following ways.

Treat you

I 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 my organization

I can use and share your health information to run my practice, improve your care, and contact you when necessary.

Example: I use health information about you to manage your treatment and services. 

 

Bill for your services

I can use and share your health information to bill and get payment from health plans or other entities. 

 

Example: I give information about you to your health insurance plan so it will pay for your services. 

 

For certain health information, you can tell me your choices about what I share. If you have a clear preference for how I share your information in the situations described below, talk to me. Tell me what you want me to do, and I will follow your instructions.

In these cases, you have both the right and choice to tell me to:

• Share information with your family, close friends, or others involved in your care or payment for your care

• Share information in a disaster relief situation

• Include your information in a hospital directory

If you are not able to tell me your preference, for example if you are unconscious, I may go ahead and share your information if I believe it is in your best interest. I may also share your information when needed to lessen a serious and imminent threat to health or safety.

With your consent, I may also use and share your information in the following ways:

• To whomever you name in a consent to share your information

• To prevent multiple enrollments in withdrawal management or maintenance treatment programs

• To report participation in treatment required by the criminal justice system

• To report prescribed substance use disorder treatment medications to a state prescription drug monitoring program when required by law

 

In these cases I never share your information unless you give me written permission:

• Marketing purposes

• Sale of your information

• Most sharing of psychotherapy notes

Our Uses and Disclosures

How do I typically use or share your health information? 

I typically use or share your health information in the following ways.

 

How else can I use or share your health information? 

I am 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. I have to meet many conditions in the law before I can share your information for these purposes.  

 

In all cases, including those listed below, if I have substance use disorder patient records about you, subject to 42 CFR part 2, I cannot use or share information in those records in civil, criminal, administrative, or legislative investigations or proceedings against you without (1) your consent or (2) a court order and a subpoena.

Help with public health and safety issues

I 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

For medical emergencies

I can share your information during a bona fide medical emergency with the personnel and health care providers responding to your emergency, even when you are unable to consent because of the emergency. 

I can also share your identifying information to assist the federal Food and Drug Administration in notifying you or your doctor about unsafe products you may be using.

Aid scientific research

I can use or share your information to conduct or help with health research. Researchers cannot include any patient identifying information in their reports about the research.

Comply with the law

I 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 I’m complying with federal privacy law.

Respond to organ and tissue donation requests

I can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

I can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Assist with cause of death inquiries

I can share patient identifying information about a deceased patient as required or allowed by laws that collect information relating to cause of death. 

Address workers’ compensation, law enforcement, and other government requests

I 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

• I can share health information about you in response to a court or administrative order, or in response to a subpoena. 

Report suspected child abuse and neglect

I will only report the information required by law. 

Prevent or reduce crime in our program

I may report to law enforcement when a patient commits or threatens to commit a crime within my program or against me. 

Legal Proceedings and Court Orders

I must follow certain procedures before using or sharing your information for investigations and legal proceedings.

• I will not use or share your information or provide testimony about your information in any civil, administrative, criminal, or legislative proceedings against you without your written consent or a court order.

• I will only respond to a court order to use or share your health information if it is accompanied by a subpoena or other similar legal mandate requiring me to comply.

• I will only use or share your information in proceedings against you based on a court order after I have received notice and an opportunity to be heard or you tell me that you have received notice. 

• I may use or share your information to respond to legal proceedings against my program based on a court order and you may not be notified in advance. You have the right to seek to overturn or change the court order after you learn about it.

 

Redisclosure According to HIPAA

When you consent to uses and disclosures for all future treatment and payment purposes and to run my business, I may share your information with substance use disorder treatment programs, doctors’ offices, and health care businesses for those activities. If the person who receives it is subject to HIPAA, then they are allowed to use and share your information again without your consent for the purposes that HIPAA allows. Your information still cannot be used in legal proceedings against you unless (1) you consent or (2) based on a Part 2 court order and a subpoena (or similar legal requirement).

 

My Responsibilities

• I am required by law to maintain the privacy and security of your protected health information. 

• I will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

• I must follow the duties and privacy practices described in this notice and give you a copy of it. 

• I will not use or share your information other than as described in this notice unless you tell me can in writing. If you tell me I can, you may change your mind at any time. Let me 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

I can change the terms of this notice, and the changes will apply to all information I have about you. The new notice will be available upon request, in my office, and on my web site.