Notice of Privacy Practices

College Psych Eval

Effective Date: 1/1/2026

This Notice describes how psychological evaluation information about you may be used and disclosed and how you can access this information. Please review it carefully.

1. Our Legal Obligations

We are required by law to:

• maintain the privacy and security of your protected health information (PHI);
• provide you with this Notice of our privacy practices;
• follow the terms of this Notice currently in effect; and
• notify you if a breach of unsecured PHI occurs.

2. Nature of Services

Our practice provides:

• psychological and psychoeducational evaluations;
• diagnostic assessments related to learning, attention, and mental health conditions; and
• written reports for college or university disability accommodations and related academic supports.

We do not provide ongoing psychotherapy and do not bill insurance.

3. Uses and Disclosures of Protected Health Information

We may use or disclose your PHI without written authorization for the following purposes:

A. Evaluation and Professional Services

To conduct psychological or psychoeducational evaluations, score and interpret assessments, prepare written reports, and consult professionally as needed for accuracy and quality of services.

B. Educational Accommodation Documentation (With Your Direction)

At your request, we may disclose evaluation results or reports to colleges or universities, disability/accessibility services offices, educational institutions, or testing organizations. Disclosures are limited to what you authorize or request and are typically provided in the form of a written report prepared for that purpose.

C. Practice Operations

For administrative purposes such as record keeping, quality assurance, professional supervision, licensing, legal compliance, and internal audits.

D. Communications (Phone/Text) and No Sale of Personal Information

Your phone number will be used exclusively to send you messages you have opted to receive based on your consent. You may opt out at any time by notifying us or replying STOP (if applicable).

We do not sell your personal information. We also do not share your personal information with third parties for their own marketing purposes. We may disclose information only as described in this Notice (e.g., at your written request, as required by law, or to vendors who help us operate our practice under appropriate confidentiality obligations).

Phone Number Privacy Policy: We respect your privacy and are committed to protecting your personal information. Use of Information: We use your phone number to send SMS messages regarding your inquiry and customer care related topics Mobile phone information or opt-in data collected will not be shared, sold, or disclosed to third parties or affiliates for marketing purposes. Opt-Out: Reply "STOP" to unsubscribe or "HELP" for assistance. Message Disclosures: Message frequency varies. Message and data rates may apply. Data Security: Your data is protected and retained only as needed.

Text us at (617) 362-7165 to connect with CollegePsychEval. You'll receive an automated SMS asking you to confirm. By confirming, you consent to receive SMS messages related to your inquiry, service requests, or appointment confirmations. Message frequency may vary. Message and data rates may apply. Reply HELP for support or STOP to opt out at any time. For details, view our Privacy Policy: https://www.collegepsycheval.com/privacy

4. Uses and Disclosures Requiring Written Authorization

We will not use or disclose your PHI for purposes outside those described above without your written authorization, except as required by law. You may revoke an authorization in writing at any time, except where action has already been taken based on your authorization.

5. Disclosures Required or Permitted by Law

We may disclose PHI without authorization when required by law, including but not limited to:

• suspected abuse or neglect of a child, elder, or disabled individual;
• serious and imminent risk of harm to you or others;
• court orders, subpoenas, or other lawful legal processes; and
• public health or oversight activities required by law.

Massachusetts law provides additional protections for mental health records, and where state law is more restrictive than federal law, we follow the stricter standard.

6. Your Rights

You have the right to:

• inspect and obtain a copy of your evaluation records (with limited legal exceptions);
• request amendments to your records if you believe information is inaccurate;
• request restrictions on certain disclosures;
• request confidential communications (e.g., alternative contact methods);
• receive an accounting of certain disclosures; and
• receive a paper copy of this Notice at any time.

Requests must be submitted in writing. We may deny requests as permitted by law and will provide a written explanation if so.

7. Records and Retention

Evaluation records are maintained securely in accordance with professional standards and Massachusetts law. Records are retained for the legally required period and then securely destroyed.

8. Complaints

If you believe your privacy rights have been violated, you may file a complaint with:

You may also file a complaint with the U.S. Department of Health and Human Services. Filing a complaint will not result in retaliation.

9. Changes to This Notice

We reserve the right to change this Notice. Updated versions will be made available upon request and posted on our website if applicable.

10. ADHD / Learning Disorder & Testing Agency Disclosures

Educational Testing and Credentialing Agencies

At your request, evaluation records or summary reports may be disclosed to educational testing agencies or credentialing bodies (e.g., colleges, universities, or standardized testing organizations) for the purpose of documenting ADHD, learning disorders, or related disabilities and requesting accommodations.

These organizations may require:

• specific test instruments;
• standardized scores;
• diagnostic statements;
• developmental and educational history;
• functional impact statements;
• evaluator credentials and licensure information.

Disclosures to testing agencies are made only with your written authorization and are limited to information required by the requesting organization. Once disclosed, the information may be subject to the receiving organization's privacy policies rather than HIPAA.

Limits of Confidentiality & Educational Disclosure Consent

College Psych Eval

Psychological & Psychoeducational Evaluation Services

Purpose of Evaluation

The purpose of this evaluation is to assess psychological, cognitive, or learning-related functioning and, when applicable, to provide documentation for college or university disability accommodations or educational testing accommodations.

Limits of Confidentiality

Information obtained during the evaluation is confidential and protected by law. However, confidentiality has the following limits:

1. Authorized Educational Disclosures

With your written consent, evaluation reports or summaries may be shared with:

• college or university disability/accessibility services;
• educational institutions; and
• standardized testing or credentialing agencies.

2. Legal and Safety Exceptions

Confidentiality may be broken without your consent if required by law, including:

• suspected abuse or neglect of a child, elder, or disabled individual;
• serious and imminent risk of harm to you or others; and
• court orders, subpoenas, or other lawful legal demands.

3. Nature of Reports

Reports prepared for educational or testing purposes are intended to be shared documents and may include diagnoses, test scores, interpretations, and functional limitations relevant to accommodation decisions.