Privacy Practices for Protected Health Information (PHI)
YOUR INFORMATION. YOUR RIGHTS. OUR RESPONSIBILITIES.
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.
Each time you visit with me a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, a plan for future care or treatment, and billing-related information. This notice applies to all records of your care generated or retained by this mental health care practice.
You have rights.
When it comes to your health information, you have certain rights. You have the right to:
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You can ask to see or get an electronic or paper copy of your record and other health information we have about you. Ask us how to do this.
We will respond to your request within the time required by law. We may charge a reasonable, cost-based fee.
We may deny access to certain information when the law allows us to do so. Psychotherapy notes are given special protection under federal law and generally are not included with your regular health record.
Texas law also gives you additional rights regarding your mental health records. In some situations, Texas law allows a mental health professional to withhold part of a record if providing it would be harmful to your physical, mental, or emotional health.
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You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
We may say “no” to your request, but we’ll tell you why in writing.
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You can ask us to contact you in a specific way (for example, home, office, or cell phone) or to send mail to a different address.
We will say “yes” to all reasonable requests.
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You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no,” for example, if it could affect your care. If we agree to your request, we may still share this information in the event that you need emergency treatment.
If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will agree to your request unless a law requires us to share that information.
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You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
The accounting does not include certain disclosures, such as those made for treatment, payment, healthcare operations, or disclosures you authorized.
We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
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You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.
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If someone has authority to act as your personal representative, such as if someone has your medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
We will make sure that person has the legal authority to act for you before we share information with them or allow them to make decisions on your behalf.
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If you believe we have violated your privacy rights, you can file a complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights.
You can 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 https://www.hhs.gov/hipaa/filing-a-complaint/index.html.
Your complaint must be in writing and should explain what you believe we did or failed to do that violated your privacy rights. You must file your complaint within 180 days of when you knew or should have known about the issue.
We will not retaliate against you for filing a complaint.
You have choices.
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
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Share information with your family, close friends, or others involved in your care or payment for your care
Share information in a disaster relief situation
Include your information in a directory
If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
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Marketing purposes
Sale of your information
Most sharing of psychotherapy notes
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We may contact you for fundraising efforts, but you can tell us not to contact you again.
If we have your substance use disorder patient records, subject to 42 CFR part 2, we will give you clear and obvious notice in advance and a choice about whether to receive fundraising communications that use your Part 2 information.
Special Note About Certain Records
Psychotherapy Notes
We may keep psychotherapy notes separately from the rest of your health record.
Most uses and disclosures of psychotherapy notes require your written permission. There are limited exceptions allowed by law, such as certain uses by your therapist for treatment, required uses under law, and certain disclosures needed to prevent a serious threat to health or safety.
Psychotherapy notes generally are not available through your regular right to access your health record.
Electronic Health Records
We may create, store, and share your health information electronically. This may include electronic health records, secure messaging, electronic billing, and other electronic systems used to provide or manage your care.
We may share your health information electronically when federal or Texas law allows us to do so. For example, we may electronically share information for your treatment, payment, or health care operations when an authorization is not required.
When the law requires your written permission, we will ask for it before sharing your information.
We use reasonable safeguards to protect your health information when it is stored or shared electronically.
Our Uses and Disclosures
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We typically use or share your health information to:
Provide treatment
We can use your health information and share it with other professionals who are treating you.
Example: We may talk with your psychiatrist to help make sure your therapy and medications work well together.
Run our practice
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services.
Get paid for services
We can use and share your health information to bill and get payment from health plans or other entities.
Example: We give information about you to your health insurance plan so it will pay for your services.
Send appointment reminders
We can use your health information to contact you about appointments.
Share treatment options and health-related services
We may use your health information to tell you about treatment options or other health-related services that may be helpful to you.
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Sometimes, we are allowed or required by law to use or share your health information for reasons that serve the public good, such as public health, safety, or research. Before we do this, we must follow all legal requirements that apply.
In all cases, including those listed below, if we have substance use disorder patient records about you, subject to 42 CFR part 2, we cannot use or share information in those records in civil, criminal, administrative, or legislative investigations or proceedings against you without (1) your consent or (2) a court order and a subpoena.
1. Help with public health and safety issues
We can share health information about you for certain situations such as:
Preventing disease
Helping with product recalls
Reporting adverse reactions to medications
Reporting suspected abuse, neglect, or domestic violence
Preventing or reducing a serious threat to anyone’s health or safety
2. Do research
We can use or share your information for health research.
3. Comply with the law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
4. Respond to organ and tissue donation requests
We can share health information about you with organ procurement organizations.
5. Work with a medical examiner or funeral director
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
6. Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
For workers’ compensation claims
For law enforcement purposes or with a law enforcement official
With health oversight agencies for activities authorized by law
For special government functions such as military, national security, and presidential protective services
7. Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
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We are required by law to maintain the privacy and security of your protected health information.
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in this notice and give you a copy of it.
We will not use or share your information other than as described in this notice unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the terms of this notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website. This notice became in effect on September 1, 2026.
For More Information or to report a problem
If you have questions about this notice or would like additional information, you may contact our Privacy Officer, by clicking “Contact Privacy Officer” below, calling 210-879-6909, or by mail at 2111 IH35S Suite 1102 New Braunfels TX 78130.
If you believe that your privacy rights have been violated, you have the right to file a complaint with our Privacy Officer or with the Secretary of the Department of Health and Human Services or Texas Health and Human Services.
The complaint must be in writing, describe the acts or omissions that you believe violate your privacy rights, and be filed within 180 days of when you knew or should have known that the act or omission occurred. We will take no retaliatory action against you if you make such complaints.
U.S. Department of Health and Human Services:
Office for Civil Rights
200 Independence Avenue, S. W.
Washington, D.C. 20201
Tel: (202) 619-0257
Toll Free: 1-877-696-6775
Texas Health and Human Services:
Complaints Management and Investigative Section
P.O. Box 141369, Austin, TX 78714-1369
Toll Free: 1-800-942-5540
Fax: (512) 834-6789
Email: lpc@dhs.state.tx.us