Do you offer EMDR therapy?

Yes. Miriam Rubino, LMFT offers EMDR therapy for trauma, PTSD, anxiety, grief, and nervous system healing both in person and online throughout California.

Do you provide ketamine-assisted psychotherapy?

Yes. Ketamine-assisted psychotherapy services include preparation, integration, and collaborative treatment with licensed medical prescribers.

Do you offer therapy in Spanish?

Yes. Miriam Rubino offers bilingual psychotherapy services in English and Spanish.

Do you work with trauma and PTSD?

Yes. The practice specializes in trauma-informed therapy including EMDR, somatic therapy, relational psychotherapy, expressive arts therapy, and psychedelic-assisted approaches.

Do you offer telehealth therapy in California?

Yes. Telehealth psychotherapy services are available throughout California.

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NOTICE OF PRIVACY PRACTICES

Miriam Rubino, M.A., LMFT #126411
Effective Date: September 2026

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

This Notice of Privacy Practices describes how I may use and disclose your protected health information (“PHI”) in connection with psychotherapy services and explains your rights regarding that information.

Your Rights

When it comes to your health information, you have certain rights.

Get a copy of your health records

You may ask to inspect or obtain an electronic or paper copy of your health record and other health information I maintain about you.

In some circumstances, access to certain records, including psychotherapy notes as specifically defined under HIPAA, may be limited as permitted by law.

Ask me to correct your health record

You may ask me to correct health information that you believe is incorrect or incomplete.

I may deny the request in certain circumstances permitted by law, but I will explain the reason for the denial in writing.

Request confidential communications

You may ask me to contact you in a specific way, such as only at a particular telephone number or email address, or to send communications to a different address.

I will accommodate reasonable requests.

Ask me to limit what I use or disclose

You may ask me not to use or disclose certain health information for treatment, payment, or healthcare operations.

I am not required to agree to every request.

If you pay for a healthcare service or item completely out of pocket, you may ask me not to disclose information about that service to your health plan for purposes of payment or healthcare operations. I will honor such a request unless disclosure is required by law.

Receive a list of certain disclosures

You may request an accounting of certain disclosures of your health information made during the six years before your request.

The accounting does not include all disclosures. For example, certain disclosures for treatment, payment, and healthcare operations are generally excluded.

Receive a copy of this Notice

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

Choose someone to act for you

If you have given someone medical power of attorney or if someone is otherwise legally authorized to act on your behalf, that person may exercise your rights and make choices regarding your health information as permitted by law.

I will verify the person's authority before taking action.

File a complaint

If you believe your privacy rights have been violated, you may contact me using the information at the end of this Notice.

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

You will not be retaliated against or denied services for filing a complaint.

Your Choices

For certain health information, you may tell me your preferences about what I disclose.

In some circumstances, such as sharing information with family members or others involved in your care, I may ask for your permission or follow your instructions as permitted by law.

For uses and disclosures not otherwise permitted by law, I will obtain your written authorization.

You may revoke an authorization in writing at any time, except to the extent that action has already been taken in reliance on that authorization.

Uses and Disclosures of Your Information

HIPAA permits me to use or disclose your health information in certain circumstances without obtaining a separate authorization.

Treatment

I may use and disclose your health information to provide, coordinate, or manage your care.

For example, with appropriate legal authority, I may communicate with another healthcare professional involved in your treatment.

Payment

I may use or disclose health information when necessary for payment-related activities.

For example, if you request documentation for out-of-network reimbursement, certain information may be provided to you or, when authorized or legally permitted, to a health plan.

Healthcare operations

I may use and disclose health information as necessary to operate my psychotherapy practice.

This may include activities such as quality assessment, professional consultation, supervision, legal or accounting services, compliance activities, and other healthcare operations permitted by law.

Whenever appropriate, I use reasonable safeguards to protect your privacy.

Other Uses and Disclosures Permitted or Required by Law

I may use or disclose health information when permitted or required by applicable federal or California law. Examples may include:

Preventing or reducing a serious and imminent threat to health or safety
Reporting suspected child abuse or neglect when required by law
Reporting suspected abuse or neglect of an elder or dependent adult when required by law
Responding to certain lawful court orders, subpoenas, or other legal processes
Complying with health oversight activities
Workers' compensation matters when authorized or required by law
Certain public health activities
Certain law-enforcement requests when legally permitted or required

California law may provide additional protections for mental health information. When California law provides greater privacy protection than HIPAA, I will follow the applicable law.

Psychotherapy Notes

HIPAA provides additional protection to “psychotherapy notes,” as that term is specifically defined by federal law.

In most circumstances, I must obtain your written authorization before using or disclosing psychotherapy notes, except for certain uses or disclosures specifically permitted by law.

Psychotherapy notes under HIPAA are distinct from the clinical record ordinarily maintained regarding your treatment.

Substance Use Disorder Information

Certain records concerning substance use disorder treatment may receive additional protections under federal law, including 42 CFR Part 2, when those requirements apply.

Information protected by Part 2 will be used and disclosed in accordance with applicable federal requirements.

Records subject to these additional protections generally may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless specifically authorized by you or permitted by applicable law.

Marketing and Sale of Information

I will not use or disclose your protected health information for marketing purposes when HIPAA requires your authorization without first obtaining that authorization.

I will not sell your protected health information without authorization where authorization is required by law.

Fundraising

I do not use your protected health information for fundraising activities.

My Responsibilities

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

I will notify you as required by law if a breach occurs that may have compromised the privacy or security of your information.

I am required to follow the privacy practices described in the Notice that is currently in effect.

I will not use or disclose your information other than as described in this Notice unless you authorize me to do so in writing or another use or disclosure is permitted or required by law.

If you provide written authorization, you may revoke it in writing at any time, subject to applicable legal limitations.

Electronic Communications and Telehealth

Electronic communications and telehealth services involve privacy and security considerations.

I use professional systems and reasonable safeguards intended to protect confidential information. Clients should use the secure communication methods provided by the practice when communicating sensitive clinical information whenever possible.

Changes to This Notice

I may change the terms of this Notice and the privacy practices described here.

Changes may apply to health information I already maintain as well as information received in the future.

When this Notice is materially revised, the current version will be available upon request and posted on my website.

Questions or Complaints

If you have questions about this Notice, would like to exercise your privacy rights, or believe your privacy rights have been violated, please contact:

Miriam Rubino, M.A., LMFT #126411
Privacy Contact
Email: therapy@miriamrubinopsychotherapy.com
California, United States

You may also file a complaint with the:

U.S. Department of Health and Human Services
Office for Civil Rights

Information about filing a complaint is available through the U.S. Department of Health and Human Services.

You will not be retaliated against for filing a privacy complaint.

Effective Date: September 2026