top of page

Heart & Hope Counseling, LLC – Notice of Privacy Practices (NPP)

Effective Date: February 9, 2026

Clients may obtain a copy of this Notice at any time.

1. Purpose of This Notice

This notice explains how your protected health information (PHI) may be used or disclosed, your rights regarding that information, and my legal obligations under the Health Insurance Portability and Accountability Act (HIPAA) and Ohio law. Please review it carefully.

Protected Health Information (PHI) includes any information that identifies you and relates to:

  • Your mental or physical health

  • Services you receive

  • Payment for services

PHI may exist in: written records, electronic records, or verbal communication.

​

2. My Commitment to Your Privacy

I am committed to protecting the confidentiality of your health information. I create and maintain records of the care and services you receive to provide quality care and meet legal requirements.

I am required by law to:

  • Keep PHI that identifies you private.

  • Provide you with this notice describing my legal duties and privacy practices.

  • Follow the terms of the notice currently in effect.

I may update this notice. Any changes will apply to all PHI I maintain. Updated versions will be available upon request, in my office, and on my website.

​

3. How PHI May Be Used and Disclosed Without Your Authorization

Protected Health Information (PHI) may be used or disclosed without your written authorization for the following purposes:

  • Treatment, Payment, and Health Care Operations (TPO): PHI may be used to provide, coordinate, or manage your care; to process payment or insurance-related documentation such as superbills; and for administrative, quality improvement, and professional consultation purposes.

  • Appointment Reminders and Services: PHI may be used to contact you regarding appointments or to provide information about treatment-related services.

  • Supervision: As a Marriage & Family Therapist Associate, information may be shared with my clinical supervisor as necessary for supervision, consultation, and quality-of-care purposes in accordance with applicable privacy laws and professional standards.

​

4. Uses and Disclosures Requiring Your Written Authorization

I will obtain your written authorization before releasing protected health information for purposes not described in this Notice, including:

  • Disclosure to individuals or providers not involved in your treatment

  • Marketing or research purposes

  • Release of psychotherapy notes (which are maintained separately and receive additional legal protections under HIPAA)

You may revoke any authorization in writing at any time, except to the extent that action has already been taken in reliance on it.

​

5. Uses and Disclosures Where You May Object

I may share PHI with a family member, friend, or other individual involved in your care or payment unless you object in whole or in part. In emergency situations, disclosures may be made as permitted or required under applicable law.

​

6. Your Rights Regarding PHI

You have the right to:

  1. Request limits on uses/disclosures: I may say no if it affects your care.

  2. Request restrictions for out-of-pocket payments: If services were paid in full, you may limit disclosures to health plans.

  3. Choose how PHI is communicated: E.g., email, phone, alternative address.

  4. Access PHI: Review and obtain electronic or paper copies, excluding psychotherapy notes. I may provide summaries instead.

  5. Amend PHI: Request corrections or additions; I will respond within 60 days in writing.

  6. Accounting of disclosures: Request a list of PHI disclosures in the last six years, excluding TPO (treatment, payment, operations).

  7. File a complaint: With me or the U.S. Department of Health & Human Services Office for Civil Rights without retaliation.

  8. Revoke authorization: Withdraw permission for disclosures at any time in writing.

​

7. Safeguards and Security

Heart & Hope Counseling, LLC utilizes reasonable administrative, physical, and technical safeguards to protect the privacy and security of your protected health information as required by federal and state law.

​

8. Changes to This Notice

I may revise this Notice of Privacy Practices. Updated notices will be posted in the office and on my website.

bottom of page