THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
I. MY COMMITMENT TO YOUR PRIVACY
I understand that information about you and your mental health care is personal. I am committed to protecting the privacy of your protected health information (“PHI”). I create and maintain clinical records of the care and services you receive in order to provide quality treatment and to comply with legal and ethical obligations.
This Notice applies to all records of your care generated by this practice, whether created or stored in paper, electronic, or other formats.
I am required by law to:
Maintain the privacy of your PHI
Provide you with this Notice of my legal duties and privacy practices
Follow the terms of the Notice currently in effect
I reserve the right to change this Notice at any time. Any changes will apply to all PHI I maintain. An updated Notice will be made available upon request and through the client portal when applicable.
II. HOW I MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
For Treatment, Payment, and Health Care Operations
Federal and state laws allow health care providers to use or disclose PHI without written authorization for purposes of treatment, payment, and health care operations.
Examples include:
Providing psychotherapy services
Consultation with other licensed health care providers
Documentation, billing, and payment processing
Practice operations such as supervision, training, or quality improvement
Disclosures for treatment purposes are not limited to the minimum necessary standard, as full access to relevant clinical information is often required to provide appropriate care.
Legal Proceedings and Disputes
If you are involved in a legal proceeding, I may disclose PHI in response to a valid court or administrative order. I may also respond to subpoenas or lawful requests when required by law, and when applicable, I will make reasonable efforts to notify you or seek protective orders.
III. USES AND DISCLOSURES THAT REQUIRE YOUR AUTHORIZATION
Psychotherapy Notes
If psychotherapy notes are maintained as defined under HIPAA (45 CFR §164.501), they are afforded special protection. Any use or disclosure of psychotherapy notes requires your written authorization unless disclosure is permitted or required by law, including but not limited to:
Use by me for treatment
Supervision or training purposes
Defense in legal actions initiated by you
Health oversight activities
Situations involving serious threats to health or safety
Marketing and Sale of PHI
I do not use or disclose your PHI for marketing purposes and do not sell your PHI.
IV. USES AND DISCLOSURES THAT DO NOT REQUIRE AUTHORIZATION
I may use or disclose PHI without your authorization as permitted or required by law, including:
Reporting suspected abuse or neglect of a child, elder, or vulnerable adult
Preventing or reducing a serious threat to health or safety
Health oversight activities such as audits or investigations
Judicial or administrative proceedings
Law enforcement purposes as required by law
Coroners or medical examiners
Workers’ compensation claims
Appointment reminders and treatment-related communications
Research activities permitted under HIPAA regulations
Specialized government functions as required by law
V. DISCLOSURES WITH OPPORTUNITY TO OBJECT
Unless you object, I may disclose relevant PHI to family members, partners, or other individuals involved in your care or payment for services, when appropriate. In emergency situations, consent may be obtained retroactively.
VI. YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You have the right to:
Request restrictions on certain uses or disclosures of your PHI (approval not guaranteed)
Request restrictions on disclosures to health plans when you have paid out-of-pocket in full
Request confidential communications in a specific manner or location
Access and receive copies of your clinical record (excluding psychotherapy notes)
Request corrections or amendments to your PHI
Request an accounting of disclosures
Receive a paper or electronic copy of this Notice at any time
Requests must be submitted in writing. Timeframes and reasonable fees may apply as permitted by law.
VII. TELEHEALTH, ELECTRONIC COMMUNICATION, AND RECORDS
Telehealth Services
Telehealth services are provided using HIPAA-compliant platforms such as SimplePractice. While safeguards are in place, no electronic system can guarantee absolute security.
You agree to:
Participate from a private location
Secure your devices and accounts
Accurately disclose your physical location at the time of service
Telehealth services are not appropriate for emergencies.
Secure Messaging & Clinical Records
All communications sent through secure portals or other HIPAA-compliant systems become part of your official clinical record and carry the same legal weight as session documentation. These records may be subject to subpoena or court order.
Electronic communication is intended for administrative matters and limited treatment-related clarification and is not monitored continuously.
Non-HIPAA Platforms
Educational programs, online communities, social media platforms, and non-clinical offerings operated by this practice are not HIPAA-compliant health care services and are not governed by this Notice. Participation in those spaces is voluntary and subject to separate terms.
VIII. RECORDING POLICY
Recording of therapy sessions by either the client or the therapist is strictly prohibited without prior written consent. Unauthorized recording may result in termination of services.
IX. COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with:
Chelsey Brooke Cole
The U.S. Department of Health and Human Services
You will not be retaliated against for filing a complaint.
X. ACKNOWLEDGMENT OF RECEIPT
By signing below, you acknowledge that you have received and reviewed this Notice of Privacy Practices and understand your rights regarding your protected health information.