NOTICE OF PRIVACY PRACTICES
Effective Date: March 19, 2026
THIS NOTICE DESCRIBES HOW MEDICAL AND MENTAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
YOUR PRIVACY IS IMPORTANT TO ME
I am committed to protecting the privacy of your health information. As a licensed professional counselor, I am required by law to maintain the privacy of your protected health information (PHI), provide you with this Notice of my legal duties and privacy practices, and follow the terms of the Notice currently in effect.
HOW I MAY USE AND DISCLOSE YOUR HEALTH INFORMATION
The following describes the ways I may use and disclose your protected health information. Not every use or disclosure will be listed, but all of the ways I am permitted to use and disclose information will fall within one of these categories.
For Treatment. I may use and disclose your health information to provide you with mental health treatment and services. For example, I may share information with other health care providers involved in your care, such as your psychiatrist or primary care physician, when necessary for your treatment.
For Payment. I may use and disclose your health information to bill and receive payment for the services I provide. For example, I may submit claims to your health insurance company and include information about the services you received.
For Health Care Operations. I may use and disclose your health information for the normal business operations of this practice. For example, I may use information to evaluate the quality of services provided or to comply with legal and professional obligations.
As Required by Law. I will disclose your health information when required to do so by federal, state, or local law.
To Avert a Serious Threat to Health or Safety. I may use and disclose your health information when necessary to prevent a serious and imminent threat to your health or safety or the health or safety of another person or the public. This includes situations involving mandatory reporting under Texas law, such as suspected abuse or neglect of a child, elderly person, or person with a disability.
For Judicial and Administrative Proceedings. I may disclose your health information in response to a court or administrative order, subpoena, or other lawful process.
For Workers' Compensation. I may disclose your health information to the extent authorized by and necessary to comply with workers' compensation or other similar programs.
Business Associates. I may share your information with third-party "business associates" (such as a billing service or records storage company) who assist me in operating this practice. These associates are required by law to protect your information.
YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION
You have the following rights with respect to your protected health information:
Right to Inspect and Copy. You have the right to inspect and receive a copy of your health information, including your clinical records. Requests must be submitted in writing. I may charge a reasonable fee for copies. In certain limited circumstances, I may deny your request.
Right to Request an Amendment. If you believe that your health information is incorrect or incomplete, you may request that I amend it. Your request must be in writing and must explain why the information should be amended. I may deny your request under certain circumstances.
Right to an Accounting of Disclosures. You have the right to request a list of certain disclosures I have made of your health information. This does not include disclosures made for treatment, payment, or health care operations, or disclosures you authorized.
Right to Request Restrictions. You have the right to request restrictions on certain uses and disclosures of your health information. I am not required to agree to your request, but if I do agree, I will comply with the restriction unless the information is needed to provide you emergency treatment.
Right to Request Confidential Communications. You have the right to request that I communicate with you about your health matters in a certain way or at a certain location. For example, you may ask that I contact you only by email or only at a specific address. I will accommodate reasonable requests.
Right to a Paper Copy of This Notice. You have the right to receive a paper copy of this Notice at any time, even if you have agreed to receive it electronically. You may request a copy by contacting me at the information above.
Right to Revoke Authorization. If you have given me authorization to use or disclose your health information for a specific purpose, you have the right to revoke that authorization in writing at any time. Your revocation will not affect any actions I took before receiving your written revocation.
MY DUTIES
I am required by law to maintain the privacy of your protected health information and to provide you with this Notice of my legal duties and privacy practices. I am required to abide by the terms of the Notice currently in effect. I reserve the right to change my privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law. If I make a material change to my privacy practices, I will update this Notice and make the revised Notice available upon request.
BREACH NOTIFICATION
In the event of a breach of your unsecured protected health information, I will notify you as required by law.
HOW TO FILE A COMPLAINT
If you believe your privacy rights have been violated, you may file a complaint with me or with the U.S. Department of Health and Human Services, Office for Civil Rights.
To file a complaint with me: Allison Jeanette Briggs, LPC Being Real, PLLC 2503 Robinhood St., Houston, TX Phone: 832-956-1508 Email: allisonlpc@on-being-real.com
To file a complaint with the federal government: U.S. Department of Health and Human Services Office for Civil Rights 200 Independence Avenue, S.W., Washington, D.C. 20201 Toll-Free: 1-877-696-6775 Website: www.hhs.gov/ocr/privacy/hipaa/complaints
You will not be penalized or retaliated against for filing a complaint.
CONTACT INFORMATION
If you have questions about this Notice or my privacy practices, please contact:
Allison Jeanette Briggs, LPC Being Real, PLLC 2503 Robinhood St., Houston, TX Phone: 832-956-1508 Email: allisonlpc@on-being-real.com Website: on-being-real.com
This Notice is effective as of: March 19, 2026