Notice Of Privacy Practices Form printable pdf download

Brighter & Brighter, PLLC

5959 West Loop South, Suite 230

Bellaire, TX 77401

713-808-9553

HIPAA Notice of Privacy Practices

This notice describes how information about you may be used and disclosed and how you

can get access to this information. Please review it carefully. If you have any questions

about this notice, please contact Cynthia Kay, LPC-S, or Anne Reeks, LPC, privacy

officers for Brighter & Brighter, PLLC, at the contact information listed above.

Our Privacy Commitment to You: Your privacy is of utmost importance to us. The

information we have about you will be held to the highest levels of confidentiality. We

are required by law to give you a notice of or privacy practices and to maintain the

privacy of your confidential information. Unless you give us permission in writing, we

will only disclose your information when we are ethically or legally required to do so.

Who Will Follow This Notice: This notice describes the information privacy practices

followed by all therapists associated with Brighter & Brighter, PLLC.

Your Confidential Information: This notice applies to the information and records we

have about your counseling, mental health status, and the care and services you receive at

this office.

How We May Use and Disclose Information About You; Special Situations: We may

use or disclose information about you without your permission for the following

purposes, subject to all applicable legal requirements and limitations:

To Avert a Serious Threat to Health or Safety: We may use and disclose confidential

information about you when necessary to prevent a serious threat to your health and

safety or the health and safety of another person. We may also disclose information

relative to the disclosure of past or present knowledge of child abuse or abuse of the

elderly or the disabled.

Required By Law: We will disclose health information about you when required to do

so by federal, state or local law.

Lawsuits and Disputes: If you are involved in a law suit or dispute, we may disclose

information about you in response to a court or administrative order. Subject to all

applicable legal requirements, we may also disclose information about you in response to

a subpoena.

Other Uses and Disclosures of Health Information: We will not use or disclose your

confidential information for any other purpose other than identified in the previous

sections without your specific, written Authorization. We must obtain your Authorization

separate from any Informed Consent we may have obtained from you. It you give us

Authorization to use or disclose confidential information about you, you may revoke that

Notice Of Privacy Practices Form