Notice of Privacy Practices
Psychotherapy Notes
The Practice maintains psychotherapy notes as that term is defined under HIPAA. Psychotherapy notes are maintained separately from the rest of the clinical record and receive additional privacy protections.
We generally must obtain your written authorization before using or disclosing psychotherapy notes. Authorization is not required in certain circumstances permitted by law, including:
- Use by the originator of the notes for your treatment.
- Use or disclosure for certain training or clinical-supervision activities permitted by HIPAA.
- Use or disclosure by the Practice to defend itself in a legal action or other proceeding brought by you.
- Use or disclosure to the U.S. Department of Health and Human Services when required for HIPAA oversight or enforcement.
- Uses or disclosures otherwise specifically permitted or required by law, including certain health-oversight activities and circumstances involving serious and imminent threats to health or safety.
Marketing and sale of phi
We will not use or disclose your PHI for marketing purposes when HIPAA requires your authorization.
We will not sell your PHI without authorization when authorization is required by law.
Other uses and disclosures of PHI not described in this Notice will be made only with your authorization unless otherwise permitted or required by law.
VI. MINORS AND PERSONAL REPRESENTATIVES
When a client is a minor, a parent, legal guardian, or other legally authorized person may act as the minor's personal representative and exercise certain privacy rights on the minor's behalf, as provided by applicable federal and Florida law.
There are circumstances in which a minor may have privacy rights concerning particular health information or in which a parent or guardian may not be treated as the minor's personal representative for a particular service or record. We will determine access to and disclosure of a minor client's PHI according to applicable law and the circumstances of the care provided.
When clinically appropriate, we encourage clear discussion among the minor client, parent or guardian, and clinician regarding confidentiality and its limits.
IX. BREACH NOTIFICATION
We are required to notify you following a breach of unsecured PHI when notification is required by applicable law.
VIII. YOUR RIGHTS REGARDING YOUR PHI
You generally have the right to inspect and obtain an electronic or paper copy of PHI maintained in a designated record set about you.
HIPAA's right of access generally does not include psychotherapy notes as defined by HIPAA.
We will respond to requests for access within the period required by applicable law. If a fee is permitted, it will be limited to an amount allowed by applicable law. In certain circumstances permitted by law, access may be denied or limited. When applicable, we will explain the reason and any available review rights.
VII. APPOINTMENT REMINDERS AND INFORMATION ABOUT SERVICES
We may use your PHI to contact you about appointments.
We may also contact you regarding treatment alternatives or health-related services that may be relevant to your care when permitted by law.
You may ask us to use particular methods or locations when communicating with you as described below.
1. Right to Inspect and Obtain Copies
If you believe PHI in your record is incorrect or incomplete, you may ask us to amend it.
We may deny the request under circumstances permitted by law. If we deny your request, we will provide a written explanation and information about applicable rights to submit a statement of disagreement.
2. Right to Request an Amendment
3. Right to Request Restrictions
You may ask us not to use or disclose certain PHI for treatment, payment, or health care operations.
We generally are not required to agree to such a request. However, when you pay a health care item or service in full out of pocket and request that we not disclose PHI concerning that item or service to your health plan for payment or health care operations, we will honor the request when required by law.
4. Right to Request Confidential Communications
You may ask us to contact you in a particular way or at a particular location—for example, at a specific telephone number or mailing address.
We will accommodate reasonable requests as required by law.
5. Right to an Accounting of Certain Disclosures
You may request an accounting of certain disclosures of your PHI.
The accounting does not include every disclosure. For example, certain disclosures for treatment, payment, and health care operations and disclosures made pursuant to your authorization generally are not included.
We will provide an accounting for the period and within the time required by applicable law. The first accounting within the applicable period will be provided without charge; a reasonable, cost-based fee may apply to additional requests when permitted by law.
6. Right to a Copy of This Notice
You may obtain a paper or electronic copy of this Notice at any time, including if you previously agreed to receive it electronically.
X. COMPLAINTS AND PRIVACY QUESTIONS
If you believe your privacy rights have been violated, have questions about this Notice, or wish to exercise a privacy right, you may contact:
**Privacy Officer**
**Sarah Hoskens, LMHC, LPC, NCC**
Embracing Balance Counseling Solutions, LLC
2096 Red Bug Lake Road #2096
Winter Springs, FL 32708
Phone: 407-496-8263
Email: [email protected]
You may also file a complaint with the **U.S. Department of Health and Human Services, Office for Civil Rights (OCR)**.
We will not retaliate against you, refuse treatment, or otherwise penalize you for filing a privacy complaint.
XI. CHANGES TO THIS NOTICE
We reserve the right to change this Notice and our privacy practices as permitted by law. A revised Notice may apply to PHI we already maintain as well as PHI we receive or create in the future.
The current version will be available on our website and upon request.
Effective Date: September 30, 2026
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.
i. OUR COMMITMENT TO YOUR PRIVACY
Embracing Balance Counseling Solutions, LLC (“the Practice,” “we,” “us,” or “our”) is committed to protecting the privacy of your health information.
We create and maintain records of the care and services you receive from the Practice. These records are necessary to provide quality care, obtain payment when applicable, conduct health care operations, and comply with legal and professional requirements.
This Notice applies to protected health information (“PHI”) maintained by Embracing Balance Counseling Solutions, LLC and describes the privacy practices followed by the Practice and members of its workforce who are permitted to access PHI, including clinicians, registered interns, administrative personnel, and others working on behalf of the Practice as applicable.
We are required by law to:
- Maintain the privacy and security of your PHI.
- Provide you with this Notice describing our legal duties and privacy practices.
- Follow the terms of the Notice currently in effect.
- Notify you following a breach of unsecured PHI when notification is required by law.
- Inform you if we are unable to agree to a restriction or request when required.
- Accommodate reasonable requests regarding how we communicate with you.
We may change the terms of this Notice. Changes may apply to all PHI we maintain, including information created or received before the change. The current Notice will be available upon request and on our website.
II. HOW WE MAY USE AND DISCLOSE YOUR PHI
We may use and disclose PHI to provide, coordinate, and manage your care. This may include communication or consultation among clinicians and other health care providers involved in your treatment and referrals to other providers.
For example, your clinician may consult with another qualified health care provider when clinically appropriate. Clinicians practicing under supervision may also discuss clinical information with their qualified supervisor as part of supervision and treatment.
treatment
We may use and disclose PHI as necessary to obtain payment for services. This may include submitting information to your health insurance plan, determining eligibility or coverage, obtaining authorization when required, processing claims, and responding to utilization-review or payment inquiries.
payment
We may use and disclose PHI for activities necessary to operate the Practice. These may include quality assessment, clinical supervision, training, credentialing, licensing, compliance activities, audits, business management, and other health care operations permitted by law.
We will limit uses and disclosures of PHI to the extent required by applicable law.
Health Care Operations
III. USES AND DISCLOSURES GENERALLY REQUIRING YOUR AUTHORIZATION
Except as otherwise permitted or required by law, we will obtain your written authorization before using or disclosing your PHI for purposes not described in this Notice.
If you give us written authorization, you may revoke it in writing at any time. Revocation will not affect information already used or disclosed in reliance on your authorization.
IV. USES AND DISCLOSURES THAT MAY BE MADE WITHOUT YOUR AUTHORIZATION
Subject to applicable federal and Florida law, we may use or disclose PHI without your written authorization in circumstances including:
- **Required by law:** When disclosure is required by federal, state, or local law.
- **Abuse, neglect, or exploitation:** When reporting is required or permitted by applicable law, including certain circumstances involving suspected abuse, neglect, or exploitation of children or vulnerable adults.
- **Serious threats to health or safety:** When permitted by law to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
- **Public health activities:** For legally authorized public-health activities.
- **Health oversight:** For authorized audits, investigations, inspections, licensing, disciplinary, or other health-oversight activities.
- **Judicial and administrative proceedings:** In response to a court or administrative order or other lawful process when the requirements of applicable law have been satisfied. Mental health and psychotherapy records may be subject to additional protections.
- **Law enforcement:** For limited law-enforcement purposes when permitted or required by law.
- **Coroners and medical examiners:** When disclosure is authorized by law.
- **Workers’ compensation:** As authorized by and to the extent necessary to comply with applicable workers’ compensation laws.
- **Specialized government functions:** For certain functions permitted by law, such as authorized military, national-security, protective-service, or correctional-institution activities.
- **Research:** PHI may be used or disclosed for research only when the requirements of applicable law have been satisfied, such as through your authorization or another legally permitted research pathway.
V. FAMILY, FRIENDS, AND OTHERS INVOLVED IN YOUR CARE
With your agreement, or when otherwise permitted by law, we may disclose PHI relevant to the involvement of a family member, friend, caregiver, or other person you identify as participating in your care or payment for your care.
When you are present and able to make decisions, we will generally give you an opportunity to agree or object when required.
In an emergency or when you are unable to express your wishes, we may make limited disclosures when permitted by law and when, in our professional judgment, the disclosure is in your best interest.
IX. BREACH NOTIFICATION
We are required to notify you following a breach of unsecured PHI when notification is required by applicable law.
VIII. YOUR RIGHTS REGARDING YOUR PHI
You generally have the right to inspect and obtain an electronic or paper copy of PHI maintained in a designated record set about you.
HIPAA's right of access generally does not include psychotherapy notes as defined by HIPAA.
We will respond to requests for access within the period required by applicable law. If a fee is permitted, it will be limited to an amount allowed by applicable law. In certain circumstances permitted by law, access may be denied or limited. When applicable, we will explain the reason and any available review rights.
1. Right to Inspect and Obtain Copies
If you believe PHI in your record is incorrect or incomplete, you may ask us to amend it.
We may deny the request under circumstances permitted by law. If we deny your request, we will provide a written explanation and information about applicable rights to submit a statement of disagreement.
2. Right to Request an Amendment
3. Right to Request Restrictions
You may ask us not to use or disclose certain PHI for treatment, payment, or health care operations.
We generally are not required to agree to such a request. However, when you pay a health care item or service in full out of pocket and request that we not disclose PHI concerning that item or service to your health plan for payment or health care operations, we will honor the request when required by law.
4. Right to Request Confidential Communications
You may ask us to contact you in a particular way or at a particular location—for example, at a specific telephone number or mailing address.
We will accommodate reasonable requests as required by law.
5. Right to an Accounting of Certain Disclosures
You may request an accounting of certain disclosures of your PHI.
The accounting does not include every disclosure. For example, certain disclosures for treatment, payment, and health care operations and disclosures made pursuant to your authorization generally are not included.
We will provide an accounting for the period and within the time required by applicable law. The first accounting within the applicable period will be provided without charge; a reasonable, cost-based fee may apply to additional requests when permitted by law.
6. Right to a Copy of This Notice
You may obtain a paper or electronic copy of this Notice at any time, including if you previously agreed to receive it electronically.
X. COMPLAINTS AND PRIVACY QUESTIONS
If you believe your privacy rights have been violated, have questions about this Notice, or wish to exercise a privacy right, you may contact:
**Privacy Officer**
**Sarah Hoskens, LMHC, LPC, NCC**
Embracing Balance Counseling Solutions, LLC
2096 Red Bug Lake Road #2096
Winter Springs, FL 32708
Phone: 407-496-8263
Email: [email protected]
You may also file a complaint with the **U.S. Department of Health and Human Services, Office for Civil Rights (OCR)**.
We will not retaliate against you, refuse treatment, or otherwise penalize you for filing a privacy complaint.
XI. CHANGES TO THIS NOTICE
We reserve the right to change this Notice and our privacy practices as permitted by law. A revised Notice may apply to PHI we already maintain as well as PHI we receive or create in the future.
The current version will be available on our website and upon request.
