Important Legal Information
Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
I. MY PLEDGE REGARDING HEALTH INFORMATION
I understand that health information about you and your health care is personal. I am committed to protecting health information about you. I create a record of the care and services you receive from me. I need this record to provide you with quality care and to comply with certain legal requirements.
This notice applies to all records of your care generated by this mental health care practice. This notice describes the ways in which I may use and disclose health information about you. It also describes your rights regarding the health information I keep about you and certain obligations I have concerning the use and disclosure of your health information.
I am required by law to:
- Make sure that protected health information (“PHI”) that identifies you is kept private.
- Give you this notice of my legal duties and privacy practices with respect to your health information.
- Follow the terms of the notice that is currently in effect.
I reserve the right to change the terms of this Notice. Any changes will apply to all health information I maintain. The new Notice will be available upon request, in my office, and on my website.
II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
The following categories describe different ways I may use and disclose health information. Not every use or disclosure in a category is listed; however, all permitted uses and disclosures will fall within one of these categories.
Treatment, Payment, and Health Care Operations
Federal privacy regulations allow health care providers with a direct treatment relationship with a client to use or disclose the client’s PHI without written authorization to carry out treatment, payment, or health care operations.
I may also disclose your PHI for the treatment activities of another licensed health care provider. For example, if I consult with another licensed clinician regarding your care, your PHI may be shared as necessary to assist in diagnosis or treatment.
Disclosures for treatment purposes are not limited to the minimum necessary standard because health care providers need access to complete information to provide quality care. Treatment includes coordination and management of care, consultations, and referrals between health care providers.
Lawsuits and Disputes
If you are involved in a lawsuit or legal dispute, I may disclose health information in response to a court or administrative order. I may also disclose health information in response to a subpoena, discovery request, or other lawful process, but only if reasonable efforts have been made to notify you or to secure a protective order.
III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION
Psychotherapy Notes
I do maintain “psychotherapy notes” as defined in 45 CFR § 164.501. Any use or disclosure of psychotherapy notes requires your written Authorization unless the use or disclosure is:
a. For my use in treating you
b. For my use in training or supervising mental health practitioners to improve their skills
c. For my use in defending myself in legal proceedings initiated by you
d. For use by the Secretary of Health and Human Services to investigate HIPAA compliance
e. Required by law and limited to the requirements of that law
f. Required for certain health oversight activities
g. Required by a coroner or medical examiner performing duties authorized by law
h. Necessary to avert a serious threat to the health or safety of you or others
Marketing Purposes
I will not use or disclose your PHI for marketing purposes without your written Authorization.
Sale of PHI
I will not sell your PHI.
IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION
Subject to legal limitations, I may use or disclose your PHI without your Authorization for the following purposes:
- When required by state or federal law
- For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety
- For health oversight activities, including audits and investigations
- For judicial and administrative proceedings, including responding to a court or administrative order
- For law enforcement purposes, including reporting crimes occurring on my premises
- To coroners or medical examiners, when such individuals are performing duties authorized by law
- For specialized government functions, including ensuring proper execution of military missions, protecting the President of the United States, conducting intelligence or counter-intelligence operations, or ensuring safety within correctional institutions
- For workers’ compensation purposes, as required by law
- For appointment reminders and to inform you about treatment alternatives or other health-related services I offer
V. USES AND DISCLOSURES REQUIRING OPPORTUNITY TO OBJECT
Disclosures to Family or Others Involved in Your Care
I may disclose your PHI to a family member, friend, or other person involved in your care or payment for care unless you object. In emergency situations, consent may be obtained retroactively.
VI. YOUR RIGHTS REGARDING YOUR PHI
You have the following rights:
- The right to request restrictions on certain uses and disclosures of your PHI (I am not required to agree if it would affect your care).
- The right to request restrictions on disclosures to health plans for services paid out-of-pocket in full.
- The right to choose how I communicate PHI to you.
- The right to inspect and obtain copies of your medical record, excluding psychotherapy notes.
- The right to request an accounting of disclosures.
- The right to request corrections or amendments to your PHI.
- The right to receive a paper or electronic copy of this Notice.
EFFECTIVE DATE
This Notice of Privacy Practices is effective March 2026.
Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have specific rights regarding your protected health information. By agreeing to this form, you acknowledge receipt of this Notice.
Messaging Terms & Conditions
You agree to receive informational messages (such as appointment reminders or account notifications) from Talk Therapy Counseling Services, PLLC.
Mobile Messaging Privacy Policy
Information Collected:
We may collect information such as your name, phone number, and email address.
Use of Information:
We may use the information collected to provide services requested, including scheduling, billing, customer service, appointment reminders, and other administrative communications.
Sharing of Information:
We may share information with payment processors or legal authorities as necessary to perform services or comply with the law. Your mobile information will not be shared, sold, rented, or used for marketing or promotional purposes. All policies comply with CTIA Guidelines 5.2.1. You may request removal of your information at any time by contacting us via our email address.
How to Request Your Records
How to Request Your Health Care Records
Clients have the right to request access to their health care records.
To request your records:
Submit a written request by email to the platform you use to access therapy:
If you use Rula you can request your records at [email protected].
If you use Sondermind, please use the following link: https://help.headspace.com/hc/en-us/articles/42256127648411-How-do-I-request-my-medical-records-from-my-SonderMind-provider#:~:text=You%20can%20choose%20to%20have,representative%20(as%20defined%20by%20HIPAA)
If you use Mindful Therapy Group, you can request your records at https://mindfultherapygroup.com/records-request/
- Include your full name, date of birth, and the specific records you are requesting.
- Requests may be subject to identity verification and applicable fees as permitted by law.
- Records will be provided within the timeframe required by Texas law.
If you have questions about requesting records, please contact the practice directly using the contact information listed on this website.
How to Make a Complaint
How to Contact the Texas Behavioral Health Executive Council
If you would like to contact the Texas Behavioral Health Executive Council (BHEC), which oversees behavioral health licensing boards in Texas, you may do so using the information below:
Texas Behavioral Health Executive Council
Website: https://www.bhec.texas.gov
Contact Page: https://www.bhec.texas.gov/contact-us
The Council can provide information about licensure, regulations, and the complaint process.
How to File a Consumer Complaint
If you believe your rights have been violated or you wish to file a consumer complaint, you may contact the Office of the Texas Attorney General’s Consumer Protection Division.
You can file a complaint online at:
https://www.texasattorneygeneral.gov/consumer-protection/file-consumer-complaint
This process is independent of the practice and allows consumers to raise concerns related to services provided in Texas.
These disclosures are provided in accordance with Texas House Bill 4224 and Texas Health & Safety Code §181.105