Notice of Privacy Practices (HIPAA)

Vitality Counseling LCSW PC: Notice of Privacy Practices
Effective date: 10/01/2026

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

Our Responsibilities

Vitality Counseling LCSW PC is required by law to maintain the privacy and security of your protected health information, provide you with this notice, follow the privacy practices described in the notice currently in effect, and notify you promptly if a breach occurs that may have compromised the privacy or security of your information. We will not use or share your information other than as described in this notice unless you authorize us in writing or the law permits or requires the use or disclosure. If you authorize a use or disclosure, you may revoke that authorization in writing at any time, except to the extent we have already acted in reliance on it.

How Vitality Counseling LCSW PC may use and disclose your information without your written authorization

Treatment. To provide, coordinate, or manage your care. For example, Vitality Counseling LCSW PC may consult with another health care provider involved in your care. In most cases Vitality Counseling LCSW PC will ask for your permission before contacting other providers, and Vitality Counseling LCSW PC will not share psychotherapy notes without your written authorization. Where state law requires your consent for a particular disclosure, Vitality Counseling LCSW PC will obtain it.
Payment. To bill and collect payment, for example sharing information with your insurance company to verify coverage or process claims.
Health care operations. For business activities such as quality assessment, supervision or consultation, licensing, and compliance.
As required or permitted by law, including:
- Reports of suspected child abuse or neglect, or abuse of an elderly or dependent adult
- Serious threats to the health or safety of you or others
- Court orders, subpoenas, and certain legal proceedings, as allowed by law
- Health oversight activities, such as licensing board investigations
- Public health, law enforcement, or national security purposes, where required
- Workers’ compensation, as required by law

Other Ways We May Use or Disclose Your Health Information

We may use or disclose your protected health information for the following purposes when permitted or required by applicable law.

Public health and safety. We may disclose information to help prevent disease, report certain events as required by law, report suspected abuse or neglect, or prevent or reduce a serious threat to health or safety.

Health research. We may use or disclose information for research when the applicable legal requirements are met.

Legal requirements and oversight. We may disclose information when required by federal or state law, or to authorized agencies conducting health oversight activities, including licensing and compliance investigations.

Law enforcement and government requests. We may disclose information for certain law enforcement or government purposes when authorized or required by law.

Workers’ compensation. We may disclose information for workers’ compensation claims as permitted or required by law.

Court proceedings. We may disclose information in response to a court or administrative order, subpoena, or other lawful process when the applicable legal requirements are satisfied.

Medical examiners and funeral directors. We may disclose information to a coroner, medical examiner, or funeral director when permitted by law.

Other legally permitted disclosures. We may disclose information for other purposes permitted by federal and state law, subject to applicable confidentiality protections and any required authorizations.

Special protections may apply to psychotherapy notes, substance use disorder records protected by 42 CFR Part 2, and other confidential mental health information. We will follow the applicable requirements for those records.

Special Protections for Substance Use Disorder Records

To the extent that Vitality Counseling LCSW PC has substance use disorder patient records subject to 42 CFR Part 2, we will not share that information for investigations or legal proceedings against you without (1) your written consent or (2) a court order and a subpoena.

Uses and disclosures that require your written authorization

Psychotherapy notes. Psychotherapy notes maintained separately from the medical record receive special protection, and Vitality Counseling LCSW PC will not disclose them without your written authorization except where law allows.
Marketing, and any sale of your PHI.
Any other use or disclosure not described in this notice.

You may revoke an authorization in writing at any time, except to the extent we have already acted on it.

Your Rights Regarding Your Health Information

You have the following rights regarding your protected health information:

Get a copy of your records. You may ask to inspect or obtain an electronic or paper copy of your medical record and other health information we maintain about you, subject to limited legal exceptions. Contact Vitality Counseling LCSW PC to learn how to submit your request. We will generally provide access within 30 days. If an extension is legally permitted, we will notify you in writing. We may charge a reasonable, cost-based fee where permitted by law.

Ask us to correct your records. You may request an amendment to health information you believe is incorrect or incomplete. Please contact Vitality Counseling LCSW PC to learn how to submit your request. We may deny your request in certain circumstances, but if we do, we will explain the reason in writing within 60 days, as required by HIPAA. If an extension is permitted by law, we will notify you in writing and explain the reason for the delay.

Request confidential communications. You may ask us to contact you in a specific way or at an alternative address or location. We will accommodate reasonable requests as required by law.

Ask us to limit what we use or disclose. You may request restrictions on certain uses and disclosures of your health information. We are generally not required to agree, except where the law requires otherwise. If you pay for a service or item in full out of pocket, you may request that we not disclose information about that service to your health plan for payment or health care operations, unless disclosure is required by law.

Request an accounting of disclosures. You may request a list of certain disclosures of your health information made during the six years before your request. Some disclosures are excluded from this accounting under applicable law. We will provide one accounting in a 12-month period without charge and may charge a reasonable, cost-based fee for additional requests within that period, as permitted by law.

Receive a copy of this notice. You may request a paper copy of this Notice of Privacy Practices at any time, even if you have agreed to receive it electronically.

Choose someone to act for you. If a person has legal authority to act on your behalf, such as a legally authorized personal representative, that person may exercise your privacy rights as permitted by law. We will verify their authority before acting on their request.

File a complaint. If you believe your privacy rights have been violated, you may contact Vitality Counseling LCSW PC using the contact information in this notice or file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

How to exercise your rights. To request access to your records, request an amendment, ask for confidential communications, request restrictions, or request an accounting of disclosures, contact Vitality Counseling LCSW PC at 631-834-8647. We will explain any applicable request procedures and respond within the time required by law.

Your Choices About How We Share Information

For certain health information, you can tell us your preferences about what we share. If you have a preference about sharing information in the situations described below, please contact Vitality Counseling LCSW PC.

Family, friends, and others involved in your care. We may share relevant information with a family member, close friend, or another person involved in your care or payment for your care when you agree, have an opportunity to object and do not object, or when otherwise permitted by law. If you are unable to express your preference, we may share information when permitted by law and when we determine it is in your best interest.

Disaster relief. We may disclose information to an authorized public or private entity assisting with disaster relief when permitted by law.

Mental health care. We will obtain your authorization for disclosures of psychotherapy notes when required by law. Other mental health information may be subject to additional federal or state confidentiality protections.

Marketing and sale of information. We will obtain your written authorization for uses or disclosures of your information for marketing or for any sale of your protected health information when required by law.

You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.

State Privacy Laws and Additional Confidentiality Protections

Vitality Counseling LCSW PC complies with applicable federal and state privacy and confidentiality laws.

Certain laws may provide additional protections for mental health records, psychotherapy notes, substance use disorder records, and other sensitive health information. When a law applicable to your records or services imposes additional requirements or restrictions on the use or disclosure of your information, Vitality Counseling LCSW PC will follow those requirements.

The specific protections applicable to your information depend on the laws governing the records and services involved. These protections may restrict disclosures that would otherwise be permitted under federal law.

Changes to This Notice

Vitality Counseling LCSW PC may change the terms of this notice, and any changes will apply to all protected health information we maintain. The current version of this notice will be available upon request and posted on our website.

Questions or Complaints

If you believe your privacy rights have been violated, you may contact Vitality Counseling LCSW PC at 631-834-8647.

You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at https://www.hhs.gov/hipaa/filing-a-complaint/index.html or by calling 1-877-696-6775.

Vitality Counseling LCSW PC will not retaliate against you for filing a complaint.

Privacy Contact: Jessica Thalhamer
Phone: 631-834-8647