Notice of Privacy Practices

Chloe Melka, MA, LPCC (#20618) | Chloe Melka - LPCC Virtual in California | 831-318-0949 | chloemelka@cmtraumatherapy.org | cmtraumatherapy.org

Effective Date: June 8, 2026

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

My Commitment to Your Privacy

What you share in therapy is deeply personal, and protecting it is a core part of my work. I am required by law to maintain the privacy of your protected health information (PHI), to give you this notice describing my legal duties and privacy practices, and to follow the terms of the notice currently in effect. PHI is information about you, including basic identifying details, that relates to your mental health, your treatment, or payment for your care.

In addition to federal law (HIPAA), I follow California privacy laws, including the California Confidentiality of Medical Information Act, and the confidentiality rules of my profession. When California law is more protective of your privacy than federal law, I follow the stricter rule.

How I May Use and Disclose Your Health Information

For treatment. I may use and share your information as needed to provide and coordinate your care. For example, I may consult with another health care provider involved in your care, such as your physician or psychiatrist, but I will ask for your written permission first unless there is an emergency.

For payment. If you use insurance, I may share information with your insurance company to bill for services, verify coverage, or respond to questions about your claim. I share only the minimum necessary information.

For health care operations. I may use your information for the administrative side of running my practice, such as quality review, professional consultation or supervision, scheduling, billing and record-keeping services, and compliance with legal obligations. Anyone who helps me with these tasks and may see your information, such as a billing service, electronic health record or telehealth platform, is required to protect it under a written Business Associate Agreement.

Appointment reminders and contact. I may contact you by phone, text, or email about appointments or other services. I will use only the contact methods you have approved, and you can change your preferences at any time.

Uses and Disclosures That Require Your Written Authorization

Other than the situations described in this notice, I will not use or share your information without your written authorization. This includes:

  • Psychotherapy notes. Psychotherapy notes (my private process notes, kept separate from your clinical record) receive special protection. I will not share them without your written authorization, except in the limited situations described below.

  • Marketing. I will not use your information for marketing purposes without your authorization.

  • Sale of your information. I will never sell your PHI.

You may cancel (revoke) an authorization at any time by telling me in writing. The cancellation will not affect anything I already did in reliance on it.

Situations Where I May Share Information Without Your Authorization

Therapy is confidential, but the law requires or allows disclosure in a small number of situations. These include:

  • Abuse of a child, an elder, or a dependent adult. California law requires me to report known or reasonably suspected abuse or neglect to the appropriate agency.

  • Serious danger to yourself or others. If I believe you are in serious and imminent danger of harming yourself, or that you pose a serious threat of violence to another identifiable person, I may take steps to protect safety, including contacting the person at risk, the authorities, or emergency services.

  • Legal proceedings. If I receive a court order, or in certain other legal or administrative proceedings, I may be required to disclose information. Therapist-client communications are generally protected by privilege in California, and I will assert that privilege on your behalf where the law allows it. Where a valid subpoena or request is not accompanied by a court order or your authorization, I will not release records without first contacting you.

  • Health oversight and licensing. The California Board of Behavioral Sciences or another oversight agency may review records as part of an audit or investigation.

  • Medical emergencies. If you are unable to give permission during an emergency, I may share information needed to get you help.

  • Law enforcement and other legal requirements. Where required by law, such as to prevent a serious threat to health or safety.

  • Workers' compensation. If you are seeking benefits through a workers' compensation claim, as required by law.

  • Deceased clients. To a personal representative or as otherwise permitted by law.

Telehealth

If we meet by video or phone, I use a secure, HIPAA-compliant platform. I do not record sessions without your written consent. You are responsible for choosing a private space for your sessions and a secure connection on your end. Please let me know if you have any concerns about privacy at your location.

Your Rights Regarding Your Health Information

  • Right to request restrictions. You can ask me to limit how I use or share your information for treatment, payment, or operations. I am not required to agree, except that if you pay for a service out of pocket in full and ask me not to share information about it with your health insurer, I will honor that request.

  • Right to confidential communications. You can ask me to contact you in a specific way (for example, only by cell phone, or only at a certain address). I will accommodate reasonable requests.

  • Right to access your records. You can ask to see or get a copy of your clinical record, in paper or electronic form. I will respond within 30 days of your written request. I may charge a reasonable, cost-based fee for copies. In limited circumstances I may decline, and if I do, I will explain why and describe your options. Psychotherapy notes are not part of the record you can request.

  • Right to request an amendment. If you believe something in your record is incorrect or incomplete, you can ask me in writing to correct it. I may deny the request in certain situations, but you may submit a statement of disagreement that will be kept with your record.

  • Right to an accounting of disclosures. You can ask for a list of certain disclosures I have made of your information, other than those for treatment, payment, operations, or those you authorized.

  • Right to a paper copy of this notice. You can ask for a paper copy at any time, even if you agreed to receive it electronically.

  • Right to be notified of a breach. If your information is ever improperly accessed or disclosed in a way that puts its privacy or security at risk, I will notify you as required by law.

To use any of these rights, contact me using the information at the top of this notice.

My Responsibilities

  • I am required by law to maintain the privacy and security of your PHI.

  • I will let you know promptly if a breach occurs that may have compromised 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 here unless you give me written permission.

Changes to this notice. I reserve the right to change this notice and to make the new terms apply to all information I already hold. If I make a significant change, I will post the revised notice on my website and in my office and give you a copy upon request.

Therapy Website Disclaimer

The therapy or counseling services offered on this website are not intended to diagnose or treat any mental health conditions. If you are experiencing any mental health concerns, it is important to seek the help of a licensed mental health professional. Our services and information are intended to complement and support, not replace, the relationship between you and your therapist or medical professional. Our services are not a substitute for professional medical or psychological care. Please seek the help of a licensed therapist or healthcare provider for any mental health concerns.

Questions and Complaints

If you have questions about this notice or believe your privacy rights have been violated, please contact me:

Chloe Melka, MA, LPCC Virtual in California | 831-318-0949 | chloemelka@cmtraumatherapy.org

You also have the right to file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights:

Office for Civil Rights, U.S. Department of Health and Human Services 200 Independence Avenue SW, Washington, DC 20201 1-877-696-6775 www.hhs.gov/ocr/privacy/complaints

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

This notice was last reviewed on October 12, 2026.