HIPAA Notice of Privacy Practices
Understanding how we protect your health information
Effective Date: January 30, 2026
About This Notice
This Notice of Privacy Practices describes how Florida Coast Counseling may use and disclose your protected health information (PHI) to carry out treatment, payment, or healthcare operations, and for other purposes permitted or required by law. It also describes your rights to access and control your protected health information.
We are required by law to:
- Maintain the privacy of your protected health information
- Give you this Notice of our legal duties and privacy practices
- Follow the terms of the Notice currently in effect
- Notify you if we are unable to agree to a requested restriction
- Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations
How We May Use and Disclose Your Protected Health Information
The following categories describe the ways we may use and disclose your protected health information. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of these categories.
For Treatment
We may use and disclose your PHI to provide, coordinate, or manage your mental health care and related services. This includes consultation with other healthcare providers concerning your treatment.
Example: We may share your treatment information with a psychiatrist who is prescribing your medication, or with your primary care physician if medically necessary.
For Payment
We may use and disclose your PHI to obtain payment for services we provide to you. This may include billing activities, claims management, and collection activities.
Example: We may submit claims to your health insurance company with information about your diagnosis, the dates you received services, and the types of therapy services provided.
For Healthcare Operations
We may use and disclose your PHI for healthcare operations purposes, including quality assessment and improvement activities, training programs, accreditation, and licensing.
Example: We may use your information for quality improvement activities, staff training, or practice management purposes. Your information will be de-identified when possible.
Other Uses and Disclosures Without Your Authorization
We may use or disclose your PHI without your written authorization in the following situations:
When disclosure is required by federal, state, or local law
For public health purposes, including disease prevention and reporting
To report suspected abuse, neglect, or domestic violence as required by law
To health oversight agencies for authorized activities such as audits, investigations, and inspections
In response to a court order, subpoena, or other lawful process
For law enforcement purposes as required by law or in response to a valid request
To prevent or lessen a serious and imminent threat to your health or safety or that of others
To coroners, medical examiners, or funeral directors as necessary
For workers' compensation or similar programs as authorized by law
Uses and Disclosures Requiring Your Written Authorization
Other uses and disclosures of your protected health information not covered by this Notice or applicable law will be made only with your written authorization. You may revoke your authorization at any time by submitting a written revocation, except to the extent that we have already taken action in reliance on your authorization.
Special Note: We will obtain your specific written authorization before using or disclosing psychotherapy notes (except for treatment, payment, or healthcare operations purposes), using or disclosing PHI for marketing purposes, or selling your PHI.
Your Rights Regarding Your Protected Health Information
You have the following rights regarding your protected health information:
Right to Request Restrictions
You have the right to request restrictions on certain uses and disclosures of your PHI for treatment, payment, or healthcare operations. You also have the right to request restrictions on disclosures to family members or others involved in your care.
Important: We are not required to agree to your request, except in the case where you pay out-of-pocket in full for a service and request that we not disclose PHI related solely to that service to your health plan for payment or healthcare operations purposes.
Right to Receive Confidential Communications
You have the right to request that we communicate with you about your health information by alternative means or at alternative locations. For example, you may request that we contact you only at work or by mail. We will accommodate all reasonable requests.
Right to Inspect and Copy
You have the right to inspect and obtain a copy of your PHI contained in your medical and billing records and other records used to make decisions about your care. We may charge a reasonable fee for copying and mailing costs.
Under limited circumstances, we may deny your request to inspect and copy your records. You may request a review of that denial by another licensed healthcare professional chosen by us.
Right to Amend
If you believe that information in your records is incorrect or incomplete, you have the right to request that we amend the information. We may deny your request if the information was not created by us, is not part of the records we keep, is not available for inspection, or is accurate and complete.
If we deny your request, you may submit a written statement of disagreement, which will be included in your records.
Right to an Accounting of Disclosures
You have the right to request an accounting of certain disclosures of your PHI made by us during the six years prior to your request. This does not include disclosures for treatment, payment, healthcare operations, or disclosures made to you or with your authorization.
Right to a Paper Copy of This Notice
You have the right to obtain a paper copy of this Notice at any time, even if you have previously agreed to receive this Notice electronically. You may request a copy from our office staff or download it from our website.
Right to Notification of a Breach
You have the right to be notified if we (or one of our Business Associates) discover a breach of your unsecured protected health information.
Our Responsibilities
We are required by law to maintain the privacy and security of your protected health information
We will provide you with notice of our legal duties and privacy practices
We will follow the terms of the notice currently in effect
We will notify you if a breach of your unsecured protected health information occurs
Changes to This Notice
We reserve the right to change this Notice at any time. We reserve the right to make the revised or changed Notice effective for health information we already have about you as well as any information we receive in the future.
The current Notice will be posted in our office and on our website. The effective date of the Notice will be listed at the top of the first page.
You may request a copy of the current Notice at any time by contacting our office.
Complaints
If you believe your privacy rights have been violated, you have the right to file a complaint with our practice or with the Secretary of the Department of Health and Human Services.
File a Complaint with Our Practice
Contact our Privacy Officer:
Florida Coast Counseling
Privacy Officer
3443 Pine Ridge Road, Suite 101
Naples, FL 34109
File a Complaint with HHS
Office for Civil Rights, U.S. Department of Health and Human Services:
Region IV Office
Atlanta Federal Center, Suite 3B70
61 Forsyth Street, S.W.
Atlanta, GA 30303-8909
Phone: 1-800-368-1019
TDD: 1-800-537-7697
You will not be penalized or retaliated against in any way for filing a complaint.
Important Notice: This is Not for Emergencies
Our services are not appropriate for emergency situations. If you are experiencing a mental health emergency or are in crisis, please use one of these resources immediately:
For Life-Threatening Emergencies:
Call 911 or go to your nearest emergency room
National Suicide & Crisis Lifeline:
Call or Text 988 (24/7 support)
Crisis Text Line:
Text "HELLO" to 741741
National Domestic Violence Hotline:
1-800-799-7233
Questions About This Notice?
If you have questions about this Notice or would like to exercise any of your rights, please contact us: