Notice of Privacy Practices

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

I. Introduction

WellNest Counseling is committed to protecting your Protected Health Information (PHI). We are required by law to maintain the privacy of PHI, inform you of our privacy practices, and notify you of any breaches of unsecured PHI. This notice applies to all records of care we maintain and explains how we may use and disclose your PHI, as well as your rights regarding this information.

WellNest Counseling, PLLC follows the terms of this Notice currently in effect and will not use or disclose PHI without your written authorization, except as described in this Notice. We reserve the right to change our practices and update this Notice accordingly. Upon request, we will provide any revised Notice to you.

PHI includes, but is not limited to:

• Medical

• Dental

• Pharmacy

• Mental Health Information

II. How We May Use and Disclose PHI

1. For Treatment

We may use and share your PHI with other healthcare professionals involved in your care without written consent. This may include coordinating care with your physician or other therapists, discussing treatment options, or sharing information between counselors for individual and group therapy.

2. For Payment

We may use your PHI to bill for services provided. This includes submitting claims, providing superbills, and receiving payment from insurance providers or other payers.

3. For Health Care Operations

We may use your PHI for administrative, operational, and quality assurance activities. This includes training programs, accreditation, licensing, and performance evaluations.

4. Legal Disclosures

• Lawsuits & Disputes:** PHI may be disclosed in response to a court order or subpoena.

• Law Enforcement & National Security:** PHI may be released for law enforcement purposes, national security, or if you are in the armed forces.

• Public Health & Oversight Activities:** PHI may be disclosed to authorities for disease prevention, audits, or investigations.

• Worker’s Compensation:** We may disclose PHI as required by worker’s compensation laws.

5. Special Disclosures

• Individuals Involved in Your Care: PHI may be shared with family or close friends involved in your care, unless you object.

• Parental Disclosures: If you are a minor, your PHI may be shared with your parent or legal guardian when permitted by law.

• Emergency Situations & Serious Threats:** We may disclose PHI when necessary to prevent serious harm to you or others.

• Appointment Reminders: We may contact you with appointment reminders or other health-related information.

6. Uses & Disclosures That Require Your Authorization

• Notes: We will only disclose therapy notes with your written consent or as required by law.

• Marketing: We will not use or disclose PHI for marketing without your written consent.

• Sale of PHI: We do not sell PHI as part of our business practices.

7. Your Health Information Privacy Rights

You have the right to:

• Request Limitations on Use & Disclosure: You may submit a written request to limit how we use or share your PHI. We may deny requests if they interfere with necessary treatment.

• Choose How We Contact You: You may request that we contact you by phone, mail, or email at a preferred location.

• Access Your Records: You can request copies of your PHI. A small fee may apply for copying and mailing.

• Request Corrections: If you believe any PHI is incorrect, you may request an amendment in writing. If denied, you may file a statement of disagreement.

• File a Complaint: If you believe your privacy rights have been violated, you can file a complaint with WellNest Counseling, PLLC or with:

  • U.S. Department of Health and Human Services

  • Texas Office of the Attorney General

  • Texas State Board of Examiners for Professional Counselor

  • Texas State Board of Marriage and Family Therapists

  • Texas State Board of Social Worker Examiners

We will provide contact information upon request. You will not be penalized for filing a complaint.

---

For any questions or concerns about this Notice, please contact us at:

**WellNest Counseling, PLLC**

13500 Midway Road, Suite 401

Dallas, TX 75244

Phone: 214-471-5058

Email: info@wellnestcounseling.com