Notice of Privacy Practices

# NOTICE OF PRIVIVACY PRACTICES

**Dunlap & Associates Counseling**

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

**Effective Date:** ______09/28/2026____________

Dunlap & Associates Counseling is committed to protecting the privacy and confidentiality of your health information. We are required by law to maintain the privacy and security of your protected health information (“PHI”), provide you with this Notice of Privacy Practices, and follow the privacy practices described in this Notice.

## HOW WE MAY USE AND DISCLOSE YOUR INFORMATION

We may use or disclose your protected health information without your written authorization when permitted or required by law, including for the following purposes:

**Treatment.** We may use and share information about you to provide, coordinate, or manage your mental health treatment. This may include communication among your therapist, clinical supervisor, other clinicians involved in your care, or other health care providers when appropriate.

**Payment.** We may use or disclose information as necessary to obtain payment for services. For example, we may provide information to your insurance company to verify benefits, obtain authorization, submit claims, or respond to requests related to payment.

**Health Care Operations.** We may use or disclose information for activities necessary to operate our practice, including quality improvement, clinical supervision, consultation, credentialing, billing, compliance activities, audits, training, and administrative functions.

**Clinical Supervision and Consultation.** Clinicians practicing under supervision may discuss relevant information regarding their clients with their clinical supervisor. Clinicians may also consult with other qualified clinicians or supervisors within Dunlap & Associates Counseling when appropriate for treatment, supervision, professional development, or continuity of care. Information shared will be limited to what is reasonably necessary for these purposes and remains subject to confidentiality requirements.

**Business Associates.** We may share information with individuals or companies that perform services on our behalf, such as billing services, electronic health record providers, or other administrative vendors. These entities are required to appropriately safeguard protected health information.

**Required by Law.** We may disclose information when federal or Pennsylvania law requires us to do so.

**Health and Safety.** Information may be disclosed when permitted or required by law to address a serious and imminent threat to the health or safety of you or another person.

**Abuse or Neglect.** Mental health professionals may be required by law to report suspected child abuse or other situations for which mandatory reporting requirements apply.

**Legal and Judicial Proceedings.** Information may be disclosed pursuant to applicable law, court order, or other legally authorized process. Mental health records may receive additional protections under federal and Pennsylvania law, and disclosure will be limited accordingly.

**Government and Regulatory Activities.** We may disclose information when legally required for activities such as health oversight, licensing investigations, audits, or other governmental functions.

## USES AND DISCLOSURES REQUIRING YOUR AUTHORIZATION

For uses or disclosures not otherwise permitted or required by law, we will obtain your written authorization.

Certain information may receive additional legal protections, including psychotherapy notes and certain substance use disorder treatment information.

In most circumstances, psychotherapy notes maintained separately from the clinical record will not be used or disclosed without your written authorization except as otherwise permitted by law.

Records relating to substance use disorder treatment may also be protected by federal law. When those protections apply, such records will be used and disclosed only as permitted under applicable federal law, including 42 CFR Part 2.

You may revoke a written authorization at any time by providing written notice, except to the extent that we have already relied upon the authorization.

We will not sell your protected health information or use it for marketing purposes in a manner requiring authorization without obtaining your authorization.

## YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION

You have certain rights regarding your protected health information.

**Right to Access Your Records.** You may request to inspect or obtain a copy of your health record, subject to certain exceptions permitted by law. We generally will provide access within the timeframe required by applicable law.

**Right to Request an Amendment.** If you believe information in your record is inaccurate or incomplete, you may request that we amend it. We may deny the request in certain circumstances, but you may submit a written statement of disagreement.

**Right to Request Restrictions.** You may request that we limit how certain information is used or disclosed for treatment, payment, or health care operations. We are not required to agree to every requested restriction except where otherwise required by law.

If you pay for a service completely out of pocket, you may request that information about that service not be disclosed to your health insurance company for purposes of payment or health care operations. We will honor such a request unless disclosure is required by law.

**Right to Request Confidential Communications.** You may ask us to communicate with you in a particular way or at a particular location, such as contacting you only at a specific telephone number or email address. Reasonable requests will be accommodated.

**Right to an Accounting of Disclosures.** You may request a list of certain disclosures of your protected health information made during the period permitted by law. This accounting does not include certain disclosures, including many disclosures for treatment, payment, and health care operations.

**Right to a Paper Copy of This Notice.** You may request a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.

**Right to Choose a Personal Representative.** If another person has legal authority to make health care decisions on your behalf, that individual may exercise your privacy rights as permitted by law.

**Right to Be Notified of a Breach.** We will notify you as required by law if a breach occurs that may have compromised the privacy or security of your protected health information.

## MINORS

When services are provided to a minor, the confidentiality rights of the minor and the rights of a parent, guardian, or other legally authorized representative will be determined according to applicable Pennsylvania and federal law.

Clinicians will discuss confidentiality and its limits with minors and their parents or guardians as appropriate to the circumstances.

## ELECTRONIC COMMUNICATION AND TELEHEALTH

Electronic communication, including email, text messaging, electronic health records, electronic billing.