Notice of Privacy Practices (HIPAA)

Brooks Counseling and Wellness
7106 NW 11th Place, Gainesville, FL 32605
352-234-6723

Your privacy matters. This notice explains how I protect your personal health information, how it may be shared, and what rights you have regarding your records. Please read it carefully and feel free to ask about anything that isn’t clear.

I. My Pledge Regarding Health Information

I understand that information about your health and care is personal. I’m committed to protecting it. I keep a record of the services you receive to provide quality care and comply with legal requirements.
This notice describes how I may use and share your health information and what your rights are regarding it.
By law, I must:

  • Keep your protected health information (PHI) private

  • Provide you this notice of my legal duties and privacy practices

  • Follow the terms of the current notice

  • Make updated versions available upon request and on my website

II. How I May Use and Disclose Health Information

I may use or disclose your PHI for treatment, payment, or health-care operations without written authorization.
Examples include consulting with another provider to coordinate care or using your information to submit billing claims. These uses are allowed to ensure quality and continuity of care.

III. Psychotherapy Notes

I keep psychotherapy notes to help me reflect on our sessions. These are separate from your general record and cannot be shared without your written authorization, except for:

  • My own treatment, supervision, or training purposes

  • Legal defense if you bring a claim against me

  • Compliance investigations or when required by law

  • Preventing serious and foreseeable harm

IV. Certain Uses and Disclosures That Don’t Require Authorization

I may use or disclose PHI without authorization when required or permitted by law, such as:

  • Reporting abuse or neglect of a child, elder, or vulnerable adult

  • Preventing serious threats to health or safety

  • Responding to a valid court order or subpoena

  • Assisting law enforcement or public-health authorities

  • Fulfilling health-oversight, research, or workers’-compensation obligations

V. Disclosures to Family or Others

You may authorize me to share information with family, friends, or others involved in your care.
If you don’t object, I may share limited details as appropriate (for instance, confirming an appointment). In emergencies, I may disclose information necessary for your safety and will discuss it with you afterward.

VI. Your Rights Regarding PHI

You have the right to:

  • Request limits on certain uses or disclosures (though I may deny requests that interfere with your care)

  • Ask that communications be sent to a specific address or phone number

  • Review or obtain a copy of your record (excluding psychotherapy notes) within 30 days of written request; a reasonable copying fee may apply

  • Request corrections to your record and receive a written response

  • Receive a list of non-routine disclosures made within the past six years

  • Request that information not be shared with your insurance if you paid for the service out-of-pocket in full

  • Obtain a paper or electronic copy of this notice at any time

VII. Questions or Complaints

If you believe your privacy rights have been violated, you may file a complaint with me or directly with the U.S. Department of Health and Human Services, Office for Civil Rights. You will not be penalized for filing a complaint.

Contact:
Brooks Counseling and Wellness
7106 NW 11th Place, Gainesville, FL 32605
352-234-6723
https://www.brooks-counseling-wellness.com/privacy

Effective Date: November 2025