THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED, DISCLOSED, AND HOW YOU THE CLIENT CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

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Your medical record contains personal information about your health. This information may identify you (the client) and relate to your past, present, or future physical or mental health condition and related health care services. This is called Protected Health Information (PHI). This Notice of Privacy Practices describes how we (Second Arrow Counseling) may use and disclose your PHI in accordance with applicable federal and Texas state laws, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Texas mental health privacy statutes. It also describes your rights regarding how you may access and control your PHI.

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We are required by law to maintain the privacy of PHI and to provide you with notice of our legal duties and privacy practices with respect to PHI. We are required to abide by the terms of this Notice of Privacy Practices. We reserve the right to change the terms of our Notice of Privacy Practices at any time. Any new Notice of Privacy Practices will be effective for all PHI that we maintain at that time. We will provide you with a copy of the revised Notice of Privacy Practices by updating your client portal, sending a copy to you in the mail upon request, or providing one at your next appointment.

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How We May Use and Disclose Health Care Information About You:

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For Care or Treatment

Your PHI may be used and disclosed to those involved in your care for the purpose of providing, coordinating, or managing your services. This includes consultation with clinical supervisors or other team members. Your authorization is required to disclose PHI to any care provider not currently involved in your care.

Example: If another physician referred you to us, we may contact that physician to discuss your care. Likewise, if we refer you to another physician, we may contact that physician to discuss your care, or they may contact us.

• HIPAA Privacy Rule, 45 CFR §§ 164.500-164.534

• Texas Health & Safety Code, Chapter 611 (Mental Health Services Confidentiality)

• Texas Occupations Code, Chapter 159 (Confidentiality of Medical Records)

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For Payment

Your PHI may be used and disclosed to parties involved in payment for care or treatment. If you pay for your care completely out of pocket with no insurance use, you may restrict disclosure of your PHI for payment purposes.

• HIPAA Privacy Rule, 45 CFR §§ 164.500-164.534

• Texas Insurance Code, Title 8 (Health Insurance)

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For Business Operations

We may use or disclose your PHI to support business activities such as quality assessment, employee review, licensing, or arranging other business activities. We may also disclose PHI when providing appointment reminders or leaving messages about questions or test results.

• HIPAA Privacy Rule, 45 CFR §§ 164.500-164.534

• Texas Health & Safety Code, Chapter 611

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Required by Law

We must disclose your PHI upon your request and to the Secretary of the Department of Health and Human Services for compliance investigations.

• HIPAA Privacy Rule, 45 CFR §§ 164.500-164.534; 42 U.S.C. § 1320d-5

• Texas Health & Safety Code, Chapter 181 and Chapter 611

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Uses and Disclosures Without Authorization

Applicable law and ethical standards permit disclosure without your authorization only in limited situations, including:

• Required by law (e.g., mandatory reporting of child abuse or neglect within 24 hours as mandated by Federal law).

• Required by court order.

• To prevent or lessen a serious and imminent threat to health or safety.

• Verbal permission: We may disclose your information to family members involved in your care with your verbal consent.

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Uses and Disclosures Requiring Your Authorization

Written authorization is required for uses and disclosures not otherwise permitted by law, including: release of psychotherapy notes, marketing purposes, and sale of PHI. You may revoke your authorization at any time in writing.

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Your Rights Regarding Your PHI

To exercise any of these rights, submit your request in writing to our Privacy Officer:

• Right to Access, Inspect, and Copy: You may inspect and obtain a copy of your PHI used to make decisions about your care, except in limited circumstances.

  • Legal References: HIPAA Privacy Rule, 45 CFR § 164.524 | Texas Health & Safety Code, Chapter 611

• Right to Amend: You may request corrections to your PHI, though we are not required to agree.

  • Legal References: HIPAA Privacy Rule, 45 CFR § 164.526

• Right to an Accounting of Disclosures: You may request a list of disclosures of your PHI outside treatment, payment, or operations, or those made with your authorization.

  • Legal References: HIPAA Privacy Rule, 45 CFR § 164.528

• Right to Request Restrictions: You may request limits on uses or disclosures of your PHI. We are not required to agree but will consider your request.

  • Legal References: HIPAA Privacy Rule, 45 CFR § 164.522

• Right to Confidential Communications: You may request that we communicate with you in a specific way or at a specific location.

  • Legal References: HIPAA Privacy Rule, 45 CFR § 164.522

• Right to a Copy of This Notice: You may obtain a paper or electronic copy of this Notice at any time.

  • Legal References: HIPAA Privacy Rule, 45 CFR § 164.520

• Right to Request Restrictions for Out-of-Pocket Payments: You may request restrictions on disclosures to health plans if you paid out-of-pocket in full for a service.

  • Legal References: HIPAA Privacy Rule, 45 CFR § 164.522(a)(1)(vi)

• Right to Correct or Update PHI: You may request corrections to your PHI; we will respond within 60 days.

  • Legal References: HIPAA Privacy Rule, 45 CFR § 164.526

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Website Privacy, Breaches, & Complaints

Any personal information you provide via our website, including your email, will never be sold or rented without your express permission. You will be notified immediately if a breach involving your PHI occurs. You have the right to file complaints against any provider or our practice. We ask that you first bring concerns to your provider or our administrative team to attempt resolution.

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Our Pledge Regarding Health Information

• Keep your PHI private.

• Provide this notice of our legal duties and privacy practices.

• Follow the terms of this notice currently in effect.

• Provide annual HIPAA training for all providers and staff.

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Additional Texas-Specific Privacy Considerations for Mental Health

• Texas law provides additional protections for mental health records, including stricter consent requirements for disclosure.

• Certain disclosures require client consent except in emergencies or as mandated by law (e.g., imminent risk of harm, abuse reporting).

• Psychotherapy notes are given special protection under both HIPAA and Texas statutes.

• Clients have the right under Texas law to request restrictions and confidential communications consistent with HIPAA but may have additional rights under state law.

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Notice of Privacy Practices - HIPAA and HB300

When you receive treatment or benefits from Second Arrow Counseling, we receive, create, and maintain information about your health, treatment, and payment for services. We will not use or disclose your information without your written authorization (permission) except as described in this notice.

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We may use and disclose your health information without your authorization for treatment, payment, and health care operations. Examples include sharing information with other health care providers, your health plan, or business associates. We may also use and disclose it for public health activities, compliance with workers compensation, averting a serious threat to health or safety, and law enforcement purposes as required by law.

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Additional privacy protections under state or federal law apply to substance abuse information, mental health information, certain disease-related information, or genetic information. We will always obtain your authorization to use or share your information for marketing purposes, to use or share your psychotherapy notes, if there is payment from a third party, or for any other disclosure not described in this notice or required by law.

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Your Privacy Rights & Our Duties

• Inspect and copy your health information, including lab reports, upon written request and subject to some exceptions.

• Receive confidential communications of your health information.

• Request amendment of your health information in our records.

• Request an accounting (a list) of certain disclosures of your health information that we make without your authorization.

• Request that we restrict how we use and disclose your health information.

• Obtain a paper copy of this notice upon request.​

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You can reach Second Arrow Counseling at (346) 246-1819 or by email at etaylorlcsw@proton.me. We are required to abide by the terms of this notice. We reserve the right to change the terms of this notice and to make the revised notice effective for all health information that we maintain.