Notice of Privacy Practices

Effective Date: June 30, 2026

This Notice describes how your protected health information may be used and disclosed, your rights regarding that information, and my legal responsibilities as your psychotherapist. Please read it carefully.

My Commitment to Your Privacy

Protecting your privacy is a fundamental part of psychotherapy. I understand that information about your health and treatment is personal and confidential. Aperture Psychotherapy is committed to protecting your protected health information (PHI) in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and applicable Illinois law. I maintain records of the care and services you receive to provide quality treatment, support continuity of care, and comply with legal and ethical obligations. This Notice applies to all records created and maintained by Aperture Psychotherapy.

How Your Information May Be Used and Disclosed

Treatment

Your health information may be used or disclosed to provide, coordinate, or manage your psychotherapy treatment. When clinically appropriate and permitted by law, this may include consultation with other treating professionals involved in your care.

Payment

Your information may be used or disclosed to obtain payment for services, including: • Submitting claims to your health insurance plan • Responding to insurance or billing inquiries • Resolving payment or claims issues

Health Care Operations

Your information may also be used for activities necessary to operate the practice, including: • Quality improvement activities • Billing and administrative audits • Professional licensing or regulatory compliance

Other Uses and Disclosures Permitted by Law

In certain situations, HIPAA permits or requires disclosure of health information without your written authorization, including: • When required by federal, state, or local law • To prevent or lessen a serious and imminent threat to your health or the safety of another person • To report suspected abuse or neglect of a child, older adult, or dependent adult, as required by law • In response to a valid court order or other lawful judicial process • For authorized health oversight activities, such as licensing board investigations Except in these circumstances, your written authorization is required before your information is used or disclosed. You may revoke an authorization at any time in writing unless I have already relied upon it.

Psychotherapy Notes

Federal law provides additional protections for psychotherapy notes maintained separately from the clinical record. As described in my Informed Consent, I do not maintain separate psychotherapy notes. All clinical documentation is incorporated into your regular clinical record and is protected under the privacy practices described in this Notice.

Your Privacy Rights

You have the right to:

Inspect or Receive a Copy of Your Health Record

You may request a paper or electronic copy of your clinical record. Reasonable copying fees may apply where permitted by law.

Request Restrictions

You may request restrictions on certain uses or disclosures of your information. Although I am not required to agree to every request, I am required to honor a request not to disclose information to your health insurance plan when you have paid for a service completely out of pocket.

Request Confidential Communications

You may ask that I contact you using a particular method or at a specific location.

Request an Amendment

If you believe information in your clinical record is inaccurate or incomplete, you may request that it be amended. Certain requests may be denied as permitted by law, and any denial will be provided in writing.

Receive an Accounting of Disclosures

You may request a record of certain disclosures of your health information made during the previous six years, excluding disclosures made for treatment, payment, or health care operations.

Receive a Copy of this Notice

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

File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with me or with the U.S. Department of Health and Human Services, Office for Civil Rights. Filing a complaint will not affect your treatment or result in retaliation. Office for Civil Rights

U.S. Department of Health and Human Services
200 Independence Avenue SW
Washington, DC 20201 Phone: 1-877-696-6775

My Responsibilities

I am required by law to:

• Maintain the privacy and security of your protected health information.

• Provide this Notice describing my legal duties and privacy practices.

• Follow the terms of this Notice currently in effect.

• Notify you if a breach occurs that may compromise the privacy or security of your protected health information.

Changes to This Notice

I reserve the right to revise this Notice at any time. Any changes will apply to both existing and future protected health information maintained by this practice. The most current version of this Notice will always be available upon request and through this website.

Contact

If you have questions regarding this Notice or my privacy practices, please contact:

Aperture Psychotherapy Daniel Karl Nennig, LCPC, CADC, NCC

875 N Michigan Avenue, Suite 3181 Chicago, Illinois 60611

(312) 600-7842

daniel@aperturepsychotherapy.com