EFFECTIVE DATE OF THIS NOTICE: This notice went into effect on January 1, 2026

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

BRIGHTER HORIZONS COUNSELING PLLC (the “Practice”) is committed to protecting your privacy. The Practice is required by federal law to maintain the privacy of Protected Health Information (“PHI”), which is information that identifies or could be used to identify you. The Practice is required to provide you with this Notice of Privacy Practices (this “Notice”), which explains the Practice's legal duties and privacy practices and your rights regarding PHI that we collect and maintain.

I. PLEDGE REGARDING HEALTH INFORMATION

Your health information is personal, and I am committed to protecting it. This information constitutes a record of the care and services you receive from me. I need this record to deliver quality care to you and to comply with certain legal requirements. This notice applies to all records of your care that I generate. It informs you about the possible ways in which I might use and disclose health information about you. It also describes your rights regarding this health information and certain obligations I have in respect to that information.

II. USE AND DISCLOSURE OF HEALTH INFORMATION

This section describes the various ways in which I may use and disclose health information. While not every use or disclosure in a category will be listed, all permitted uses and disclosures will fall within one of these categories.

I am required by law to:

1. Ensure Privacy: I am obligated to ensure that health information that identifies you, also known as Protected Health Information (PHI), is kept private.

2. Provide Notice: I must provide you with this notice of my legal duties and privacy practices with respect to your health information. This notice details the ways in which I might use your health information and the circumstances under which I might disclose it.

3. Follow Notice Terms: I am bound to follow the terms of the notice currently in effect.

4. Notice Changes: I can change the terms of this Notice, and such changes will apply to all information I have about you. The new Notice will be available upon request, in my office, and on my website.

Your Rights Regarding Your Health Information

You have the following rights regarding the health information I maintain about you:

1. Right to Inspect and Copy: You have the right to inspect and copy your health information, such as health and billing records, that I use to make decisions about your care.

2. Right to Amend: If you believe the health information I have about you is incorrect or incomplete, you may ask me to amend the information.

3. Right to an Accounting of Disclosures: You have the right to request an “accounting of disclosures,” which is a list of the disclosures I made of your health information.

4. Right to Request Restrictions: You have the right to request a restriction or limitation on the health information I use or disclose for treatment, payment, or health care operations.

5. Right to Request Confidential Communications: You have the right to request that I communicate with you about medical matters in a certain way or at a certain location.

6. Right to a Paper Copy of This Notice: You have the right to a paper copy of this notice at any time.

 

For Treatment, Payment, or Health Care Operations: Federal privacy rules allow healthcare providers who have a direct treatment relationship with the patient/client to use or disclose the patient/client’s personal health information without the patient’s written authorization. This is done to carry out the health care provider’s own treatment, payment, or health care operations.

For instance, if a clinician were to consult with another licensed healthcare provider about your condition, we would be permitted to use and disclose your personal health information, which is otherwise confidential, to assist the clinician in diagnosing and treating your mental health condition. Disclosures for treatment purposes are not limited to the minimum necessary standard because therapists and other health care providers need access to the full record and/or complete information to provide quality care. The term “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers, and referrals of a patient for health care from one health care provider to another.

Substance use disorder (SUD) treatment records cannot be used for investigation or prosecution without written consent or a court order. Records used in audits or evaluations also require patient consent or a court order to be disclosed. Separate consent is required for using or sharing SUD counseling notes. Records disclosed to HIPAA-covered entities may be redisclosed per HIPAA rules. De-identified SUD records may be shared with public health authorities. SUD records and testimony are protected in legal proceedings without consent or a court order. Unauthorized disclosures will be reported per applicable laws.

SUD patients have rights under the HIPAA Privacy Rule, including requesting restrictions on disclosures to health plans for services paid in full, obtaining a disclosure accounting for the past three years, and opting out of fundraising communications. Clinicians may use discretion when granting access to SUD records.

Brighter Horizons Counseling cannot use or disclose your health information to investigate or penalize you for seeking, obtaining, or providing lawful reproductive healthcare, such as contraception, pregnancy management, or fertility treatments, or for related activities like arranging for care.

Lawsuits and Disputes: If you are involved in a lawsuit, I may disclose health information in response to a court or administrative order. I may also disclose health information about your child in response to a subpoena, discovery request, or other lawful processes by someone else involved in the dispute. However, this will only be done if efforts have been made to inform you about the request or to obtain an order protecting the requested information.

III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:

1. Psychotherapy Notes: As a psychotherapist, I maintain “psychotherapy notes” as defined in 45 CFR § 164.501. These notes document or analyze the contents of our conversation during therapy sessions. The use or disclosure of these notes requires your explicit authorization, except in the following circumstances:

• Treatment: The notes may be used for your treatment. This includes all activities that I perform to diagnose and treat your health condition.

• Training or Supervision: The notes may be used in the training or supervision of other mental health practitioners. This helps them improve their skills in group, joint, family, or individual counseling or therapy.

• Legal Proceedings: If you initiate legal proceedings against me, I may use the notes to defend myself.

• Health and Human Services Investigation: The Secretary of Health and Human Services may access these notes to investigate my compliance with HIPAA.

• Legal Requirement: If the law requires the disclosure of these notes, I will comply. However, the use or disclosure will be limited to what the law requires.

• Health Oversight Activities: The law may require the disclosure of these notes for certain health oversight activities pertaining to the originator of the psychotherapy notes.

• Coroner’s Duties: A coroner who is performing duties authorized by law may require the disclosure of these notes.

• Averting Threats: If there is a serious threat to the health and safety of others, the law may require the disclosure of these notes to help avert the threat.

2. Marketing Purposes: As a psychotherapist, I am committed to maintaining the confidentiality of your Protected Health Information (PHI). I will not use or disclose your PHI for marketing purposes. This means I will not use your health information to send you any marketing materials without your consent.

3. Sale of PHI: I value the trust you place in me as your psychotherapist. I will not sell your PHI in the regular course of my business. This means I will not sell lists of my patients or any information about my patients to third parties

IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION:

1. Disclosure Required by Law: There may be circumstances where I am legally obligated to disclose your PHI. This could be due to state or federal laws that mandate the reporting of certain types of information. In such cases, the use or disclosure will comply with and be limited to the relevant requirements of such law.

2. Public Health Activities: Your PHI may be disclosed for public health activities. This could include reporting suspected child, elder, or dependent adult abuse. It could also involve actions aimed at preventing or reducing a serious threat to anyone’s health or safety.

3. Health Oversight Activities: Your PHI may be disclosed for health oversight activities. These activities could include audits and investigations necessary for the oversight of the healthcare system, government healthcare programs, and compliance with civil rights laws.

4. Judicial and Administrative Proceedings: Your PHI may be disclosed in the course of any judicial or administrative proceeding in response to a court or administrative order. However, my preference is to obtain an Authorization from you before doing so.

5. Law Enforcement Purposes: If a crime occurs on my premises, I may disclose your PHI to law enforcement officials.

6. Coroners or Medical Examiners: Your PHI may be disclosed to coroners or medical examiners performing duties authorized by law. This could be necessary, for example, to identify a deceased person or determine the cause of death.

7. Research Purposes: Your PHI may be used for research purposes. This could include studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.

8. Specialized Government Functions: Your PHI may be disclosed for specialized government functions. This could include ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counter-intelligence operations; or helping to ensure the safety of those working within or housed in correctional institutions.

9. Workers’ Compensation: Your PHI may be disclosed in order to comply with workers’ compensation laws. Although my preference is to obtain an Authorization from you, there may be circumstances where this is not possible or practical.

10. Appointment Reminders and Health-Related Benefits or Services: I may use and disclose your PHI to contact you to remind you that you have an appointment with me. I may also use and disclose your PHI to inform you about treatment alternatives, or other healthcare services or benefits that I offer.

V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT.

Disclosures to Family, Friends, or Others: As a psychotherapist, I may need to provide your Protected Health Information (PHI) to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care. This could include information about your general condition, location (such as in a hospital), or death. However, you have the right to object to such disclosures, either in whole or in part. If you do not object, I may disclose relevant PHI to those individuals. The information disclosed would be directly relevant to the person’s involvement in your healthcare or payment related to your healthcare. For example, I may disclose information about your current physical condition to a spouse, sibling, parent, or other family member. In cases of emergency or incapacity, I may need to disclose your PHI to ensure your health and safety. In such cases, I will obtain your consent retroactively as soon as practically possible after the disclosure. For example, if you are unconscious or in severe distress, I may share your PHI with a family member, friend, or other person who can help ensure your care.

VI. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:

1. The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask me not to use or disclose certain PHI for treatment, payment, or health care operations purposes. I am not required to agree to your request, and I may say “no” if I believe it would affect your health care.

2. The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full. You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full.

3. The Right to Choose How I Send PHI to You. You have the right to ask me to contact you in a specific way (for example, home or office phone) or to send mail to a different address, and I will agree to all reasonable requests.

4. The Right to See and Get Copies of Your PHI. Other than “psychotherapy notes,” you have the right to get an electronic or paper copy of your medical record and other information that I have about you. I will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request, and I may charge a reasonable, cost-based fee for doing so.

5. The Right to Get a List of the Disclosures I Have Made. You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, payment, or healthcare operations, or for which you provided me with an Authorization. I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list I will give you will include disclosures made in the last six years unless you request a shorter time. I will provide the list to you at no charge, but if you make more than one request in the same year, I will charge you a reasonable cost-based fee for each additional request.

6. The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that I correct the existing information or add the missing information. I may say “no” to your request, but I will tell you why in writing within 60 days of receiving your request.

7. The Right to Get a Paper or Electronic Copy of this Notice. You have the right to get a paper copy of this Notice, and you have the right to get a copy of this notice by e-mail. And, even if you have agreed to receive this Notice via e-mail, you also have the right to request a paper copy of it.

8. The Right to Choose Someone to Act for You. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights.

9. The Right to Breach Notification. If there is a breach of unsecured PHI concerning you, I may be required to notify you of this breach, including what happened and what you can do to protect yourself.

COMPLAINTS

If you believe I have violated your privacy rights, please discuss your concerns with me. You have the right to file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. I will not retaliate against you for filing a complaint.

BRIGHTER HORIZON COUNSELING RESPONSIBILITIES
• The Practice is required by law to maintain the privacy and security of PHI.
• The Practice is required to abide by the terms of this Notice currently in effect. Where more stringent state or federal law governs PHI, the Practice will abide by the more stringent law.
• The Practice reserves the right to amend Notice. All changes are applicable to PHI collected and maintained by the Practice. Should the Practice make changes, you may obtain a revised Notice by requesting a copy from the Practice, using the information above, or by viewing a copy on the website www.restorationcouselingpllc.org.
• The Practice will inform you if PHI is compromised in a breach.

Acknowledgment of Receipt of Privacy Notice

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have certain rights regarding the use and disclosure of your protected health information. By checking the box below, you are acknowledging that you have received a copy of HIPAA Notice of Privacy Practices.