This is to inform you what data I am collecting from you and what I intend to do with it.
What data do I keep and why do I need it?
Name and age – this is basic information that helps me get to know you.
Address, email address, phone number – I use this as a way of contacting you regarding your sessions. I will mainly use email but if I cannot reach you, I will try a different method.
Next of kin/medical professional’s details – If I was worried that you were at risk then I may need to contact your next of kin or medical professional, if I can.
Session notes – I keep brief notes of our session(s) in writing.
Will I share your data and if I do, who will I share it with and for what purpose?
It is very unlikely that I will share your data. I will not sell it or use it for unethical reasons. I may have to share it if my notes are subpoenaed by court; if you or anyone you tell me about is at harm or risk of harm; in cases of fraud or crime; when minors (under 18 years old), dependent adults, or elders are involved; or where a referring GP or other healthcare professional requires a report, I may have to pass this information on. I may also discuss your case with other colleagues but I will keep your full name and identity confidential unless you’ve given permission otherwise.
How will I store your data?
It is mainly stored as hard copy in a locked filing cabinet. Immediately after the work is finished, I transfer the data with your initials to my password protected computer. Your phone number(s) may be kept in my business mobile phone with your first name and last initial. Only I will access your information.
How long will I store your data for and how will I dispose of it?
I will keep your details and session notes for the time required by California law (currently 7 years).
After this time I will destroy any document with your personal information and delete your phone number out of my mobile phone.
You consent to your data being used as set out above.
8601 Lincoln Blvd., Ste 180-228
Los Angeles, CA 90045
Email Address: email@example.com