Notice of Privacy Practices

Marty Ross MD Clinic

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.

Effective date: October 30, 2026

About this notice

Marty Ross MD Clinic (Good Morning M!, PLLC, dba Marty Ross MD Clinic) is required by law to protect the privacy of your health information. This notice explains how we may use and share your protected health information (PHI), your rights over it, and our legal duties. It applies to all records of your care that we create or keep, whether you are seen in the office or by telemedicine.

Privacy Officer: Marty Ross, MD
Phone: 800-470-7217
Mailing address: 1500 Westlake Ave N STE 204, Seattle, WA 98109
Email: reception@martyrossmd.com

If you have questions about this notice or want to use any of your rights, contact our Privacy Officer.

How we use and share your information for care, payment and operations

We may use and share your PHI for the following purposes without your written authorization.

  • Treatment. To provide, coordinate and manage your care. Examples: sharing information with laboratories, pharmacies, imaging centers, specialists or other clinicians treating you, and sending prescriptions electronically.

  • Payment. To get paid for the care we provide. Our clinic does not bill health insurance for visits; you pay us directly. We may still share limited information with a health plan or pharmacy benefit manager when you ask us to, such as submitting a prescription prior authorization or giving you a receipt or superbill to send to your plan.

  • Health care operations. To run our practice, such as quality review, staff training, legal and accounting services, audits and compliance.

  • Appointment reminders and health information. To contact you about appointments, test results, and treatment options or health-related services that may interest you.

  • Business associates. Some services are provided by outside companies, such as our electronic health record, telemedicine, scheduling, and clinical documentation vendors. They may receive your PHI only to do work for us, and each must sign a written agreement to protect it.

  • People involved in your care. We may share relevant information with a family member, friend or other person you identify who is involved in your care or payment for it. You may tell us not to. In an emergency or if you cannot agree, we will use professional judgment.

  • Incidental disclosures. Limited disclosures may occur as a by-product of an otherwise permitted use, despite reasonable safeguards.

Other uses and disclosures allowed or required by law

We may also use or share your PHI without your authorization in these situations, limited to what the law allows:

  • As required by law: federal, state or local law.

  • Public health: reporting communicable diseases (including certain tick-borne illnesses), adverse drug reactions, product problems, and preventing serious disease or injury.

  • Abuse, neglect or domestic violence: reporting to authorized government agencies as required or permitted by law.

  • Health oversight: audits, inspections, licensure and investigations by agencies such as the Washington Medical Commission.

  • Lawsuits and legal proceedings: in response to a court order, or a subpoena or other lawful process when legal conditions are met.

  • Law enforcement: for limited purposes, such as responding to a court order or warrant, or identifying a suspect or missing person.

  • Serious threat to health or safety: to prevent or lessen a serious and imminent threat to you, another person or the public.

  • Coroners, medical examiners and funeral directors: as needed to carry out their duties.

  • Organ and tissue donation: to organizations that handle donation and transplantation.

  • Research: when approved through a process that protects your privacy, such as an institutional review board waiver.

  • Specialized government functions: military, veterans, national security and protective services, as authorized by law.

  • Workers’ compensation: as authorized by workers’ compensation laws.

  • Secretary of HHS: to show our compliance with HIPAA.

Stricter state law. Washington law (including the Uniform Health Care Information Act, RCW 70.02) gives extra protection to some information, such as mental health records, sexually transmitted infection and HIV information, and reproductive and sexual health information. When state law is more protective than HIPAA, we follow state law.

Substance use disorder treatment records. If we receive records from a federally assisted substance use disorder treatment program covered by 42 CFR Part 2, those records have extra federal protection. We will not use or share them, or testimony describing them, in any civil, criminal, administrative or legislative proceeding against you unless you give specific written consent or a court orders it after notice and an opportunity to be heard, as Part 2 requires. A court order used this way must be accompanied by a subpoena or similar legal requirement before disclosure. Part 2 records we receive under your general consent for treatment, payment and health care operations may be used and redisclosed as HIPAA permits, unless the consent or law says otherwise. Other uses and disclosures of these records that Part 2 prohibits or materially limits will follow those stricter rules.

Uses that require your written authorization

We must get your written authorization before we:

  • Use or share psychotherapy notes, except in limited cases the law allows.

  • Use or share your PHI for marketing, or receive payment for marketing communications.

  • Sell your PHI.

  • Make any other use or disclosure not described in this notice.

We do not use PHI for fundraising. You may revoke an authorization at any time in writing to our Privacy Officer. Revocation stops future uses and disclosures but does not undo actions we already took in reliance on it.

Your rights

To use any of these rights, contact our Privacy Officer. Some requests must be in writing.

  • Get a copy of your records. You may see or get a paper or electronic copy of your medical and billing records. You may ask us to send a copy to another person you name. We will respond within 30 days, or sooner if state law requires. We may charge a reasonable, cost-based fee.

  • Ask us to correct your records. If you think information is incorrect or incomplete, you may ask us to amend it. We may deny the request and will tell you why in writing within 60 days. You may then submit a statement of disagreement.

  • Request confidential communications. You may ask us to contact you a certain way (for example, a different phone number or mailing address). We will agree to all reasonable requests and will not ask why.

  • Ask us to limit what we use or share. You may ask us not to use or share certain information for treatment, payment or operations. We are not required to agree, except in one case: if you pay for a service in full out of pocket, and ask us not to share information about it with your health plan, we must agree unless the law requires the disclosure.

  • Get a list of disclosures. You may ask for a list (accounting) of the times we shared your PHI in the six years before your request. The list will not include disclosures for treatment, payment or operations, ones you authorized, and certain others. One list per year is free; we may charge a reasonable, cost-based fee for more.

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

  • Choose someone to act for you. If someone holds your medical power of attorney or is your legal guardian, that person may use your rights. We will confirm their authority first.

  • Be notified of a breach. We will notify you if a breach occurs that compromises the privacy or security of your unsecured PHI.

Our responsibilities

  • We are required by law to maintain the privacy and security of your PHI.

  • We will let you know promptly if a breach occurs that may have compromised your information.

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

  • We will not use or share your information other than as described here unless you tell us we can in writing.

Changes to this notice

We may change this notice, and the changes will apply to all information we have about you. The new notice will be posted in our office and on our website, and a copy will be available on request.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer at 800-470-7217 or reception@martyrossmd.com. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, at www.hhs.gov/ocr/complaints, by calling 1-800-368-1019, or by writing to 200 Independence Avenue SW, Washington, DC 20201. Complaints about substance use disorder records covered by 42 CFR Part 2 may be filed in the same ways.

We will not retaliate against you for filing a complaint.