Lindsay Wakayama PsyD, A Professional Psychology Corporation

Lindsay Wakayama, Psy.D. | California Licensed Psychologist, PSY 32164

Effective date: September 10, 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 this notice covers

This notice describes the privacy practices of the professional corporation identified above for services provided through Dr. Wakayama's private practice. In this notice, "I" refers to Dr. Wakayama acting for the corporation. Protected health information includes information that identifies you and relates to your health, care, or payment for care, whether electronic, written, or spoken. These protections apply even when you pay privately.

My responsibilities

I am required by law to protect the privacy of your health information, provide this notice of my legal duties and privacy practices, and follow the notice currently in effect. I must notify affected individuals after a breach of unsecured protected health information as required by law. California telehealth rules also require immediate notice of known data breaches or unauthorized dissemination of data. I use appropriate safeguards and require privacy protections from service providers, including business associate agreements when required.

Treatment, payment, and practice operations

The following uses and disclosures may occur without a separate written authorization when allowed by HIPAA and California law. The additional protections described on the next page apply throughout this notice.

Treatment. I use your information to assess your concerns, plan treatment, and provide care. For example, I document symptoms and progress and may consult with another treating professional to coordinate care. I obtain authorization when required for a particular disclosure.

Payment. I use information to prepare bills, process payment, and resolve payment questions. For example, a private-pay invoice identifies the service date and charge. A superbill requested by you may include a diagnosis and service codes. Any disclosure to a payer is limited to what is permitted or required, and applicable restrictions on health-plan disclosures are honored.

Practice operations. I use information to manage the practice, maintain records, review the quality of care, and meet professional obligations. For example, a contracted records service may maintain your chart, or a professional advisor may review information needed to address a practice matter, subject to legally required confidentiality protections.

I may contact you about appointments, billing, treatment coordination, or relevant treatment alternatives and services. Tell me your communication preferences. Routine email, voicemail, and portal messages are not a substitute for a clinical appointment or emergency care.

When information may be shared

California law and other additional protections

When California or another applicable law gives your information greater protection than HIPAA, I follow the more protective rule. This includes California medical-confidentiality law and psychotherapist-patient privilege. Certain requests for outpatient psychotherapy information require a detailed written request and patient notification, subject to statutory exceptions. These requirements do not create permission to disclose information that would otherwise be protected.

Other legally permitted or required disclosures

Safety and reporting. I may disclose information to report suspected child abuse or neglect, reportable elder or dependent-adult abuse or neglect, or other matters required by law. I may share information with people able to reduce a serious and imminent threat and take legally required steps to protect a reasonably identifiable victim.

Public health and oversight. Information may be shared for legally authorized public-health activities, such as disease reporting or product-safety concerns, and with agencies authorized to audit, license, or oversee health care. This includes HHS review of HIPAA compliance.

Legal and governmental matters. I may respond to a valid court order or other enforceable legal requirement only after applying required protections. A subpoena or request alone does not automatically override confidentiality or privilege. Law-enforcement requests, workers' compensation disclosures, and special government functions, such as military or national-security activities, must meet all applicable legal conditions.

Other limited purposes. Information may be disclosed for approved research when authorization is obtained or a legally permitted exception and safeguards apply; to authorized coroners, medical examiners, or funeral directors; and for organ or tissue donation when legally permitted. Limited information may also be shared for disaster relief or necessary care in a custodial setting, subject to applicable protections.

Family, support people, and emergencies. With your permission, I may share relevant information with someone involved in your care or payment, obtaining written authorization when required. Paying for your care does not automatically entitle a person to your treatment records. If you cannot express your wishes, a limited disclosure may be made in your best interests or for safety only as permitted by law.

When your written authorization is required

I obtain your written authorization for uses or disclosures not described in this notice and for other uses that legally require it. These include most uses or disclosures of separately maintained psychotherapy notes, marketing that requires authorization, and the sale of protected health information. Psychotherapy notes have a specific legal meaning and are different from ordinary treatment and progress records. You may revoke an authorization in writing, except to the extent I have already acted in reliance on it or another legal exception applies.

Extra protection for certain substance use disorder records

If I receive or maintain records protected by 42 CFR Part 2, additional restrictions apply. Those records, or testimony about their contents, may not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you without your written consent or a qualifying court order. Before that order, you or the record holder must receive notice and an opportunity to be heard. The order must also be accompanied by a subpoena or another legal requirement compelling disclosure. Other Part 2 consent requirements and protections remain applicable. Not every mention of substance use in a psychotherapy record is a Part 2 record.

Your rights and how to exercise them

Contact me on my contact page or through the patient portal to ask questions or exercise a right. I may ask you to submit a request in writing and verify your identity. Avoid sending unnecessary clinical details by ordinary email.

Access and copies

You may ask to inspect or receive a paper or electronic copy of your treatment and billing information. I follow applicable California deadlines, generally inspection within five working days and copies within 15 days after a qualifying request, subject to lawful exceptions. Any fee must be permitted by law and reasonable and cost-based. Access will not be withheld solely because a treatment bill is unpaid. HIPAA excludes separately maintained psychotherapy notes from its access right; any additional California access rights still apply. If access is limited, I will explain the reason and available review rights.

Corrections and an accounting of disclosures

Amendments. You may request an amendment if you believe information is inaccurate or incomplete. I generally respond within 60 days, or give written notice of a permitted extension. If I deny the request, I explain why and how to submit a statement of disagreement.

Accounting. You may request an accounting of certain disclosures during the preceding six years. It generally excludes disclosures for treatment, payment, and health care operations and those made with your authorization. I generally respond within 60 days, subject to a permitted extension. One accounting in a 12-month period is free; I will tell you about any permitted fee for another and allow you to withdraw or modify the request.

Restrictions and confidential communications

You may ask me to limit uses or disclosures for treatment, payment, or operations, including information shared with people involved in your care. I am not required to agree to every request. However, when a service is paid in full out of pocket by you or someone other than your health plan, I must honor a request not to disclose information about that service to your health plan for payment or operations, unless disclosure is required by law. Tell me before a disclosure occurs.

You may request contact by a particular method or at a different address. I accommodate reasonable requests without requiring an explanation. A person legally authorized to act as your personal representative may exercise applicable rights after I verify their authority, subject to legal exceptions. You may obtain a paper copy of this notice at any time, even if you accepted an electronic copy.

Questions and complaints

Privacy contact: Lindsay Wakayama, Psy.D., Privacy Officer

You may submit a privacy complaint to me using the contact information above. You may also complain directly to the U.S. Department of Health and Human Services, Office for Civil Rights, through its complaint portal at ocrportal.hhs.gov, by email to OCRComplaint@hhs.gov, or by writing to: Centralized Case Management Operations, HHS, 200 Independence Avenue SW, Room 509F HHH Building, Washington, DC 20201. You do not need to complain to me first. I will not retaliate against you for making a complaint or exercising your privacy rights.

Changes to this notice

I reserve the right to revise this notice as permitted by law and apply revised practices to information I already maintain as well as new information. The current notice will be available on request and posted on the practice website. A paper or electronic copy is available without charge. Acknowledgment of receipt is handled in the informed-consent form and is not permission for disclosures that require a separate authorization.