WILDLIGHT COUNSELING
NOTICE OF PRIVACY PRACTICES
Chelsea Roush, MA, LPC
chelsea@wildlightcounseling.co
Effective Date: August 12, 2026
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, HOW YOU CAN ACCESS THIS INFORMATION, AND YOUR RIGHTS REGARDING YOUR HEALTH INFORMATION. PLEASE REVIEW IT CAREFULLY.
I. My Commitment to Your Privacy
Your health information is personal, and protecting it matters.
Wildlight Counseling creates and maintains records related to the care and services you receive. These records are necessary to provide treatment, operate the practice, process payment when applicable, and comply with legal and professional requirements.
This Notice describes how your protected health information, or PHI, may be used and disclosed, the rights you have regarding your information, and Wildlight Counseling's responsibilities for protecting it.
Wildlight Counseling is required by applicable law to:
• Protect the privacy and security of PHI that identifies you.
• Provide you with this Notice describing legal duties and privacy practices concerning your health information.
• Follow the terms of the Notice currently in effect.
• Notify you following a breach of unsecured PHI when notification is required by law.
• Provide appropriate notice concerning rights and responsibilities related to records protected by 42 CFR Part 2 when applicable.
Wildlight Counseling may change the terms of this Notice. Changes may apply to information already maintained as well as information received in the future. The current Notice will be available upon request and through Wildlight Counseling's website as applicable.
II. How Your Health Information May Be Used and Disclosed
Treatment
Your PHI may be used and disclosed to provide, coordinate, or manage your treatment.
For example, information may be shared with another healthcare professional involved in your care when permitted by law and appropriate for your treatment.
Payment
Your PHI may be used or disclosed as necessary for payment activities.
This can include processing payments, providing documentation you request for possible out-of-network reimbursement, or communicating with another responsible payer when legally authorized.
Healthcare Operations
Your PHI may be used or disclosed for appropriate healthcare operations, such as practice administration, quality improvement, professional consultation, legal or compliance activities, and other activities permitted by law.
Disclosures for treatment purposes are generally not subject to HIPAA's minimum necessary standard because healthcare professionals may need appropriate information to provide effective care.
Substance Use Disorder Records Protected by 42 CFR Part 2
To the extent Wildlight Counseling creates, maintains, or receives substance use disorder patient records that are protected by 42 CFR Part 2, additional federal confidentiality protections apply.
Part 2 may impose requirements beyond those ordinarily applicable under HIPAA, particularly regarding disclosure and the use of SUD records in legal proceedings against a patient.
Where Part 2 applies, Wildlight Counseling will handle those records according to the applicable Part 2 requirements.
Lawsuits, Legal Proceedings & Court Orders
Wildlight Counseling may disclose health information in response to a valid court or administrative order or other lawful process when permitted or required by law.
Additional protections may apply to psychotherapy notes, certain mental health records, and records protected by 42 CFR Part 2.
Part 2 records generally may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you without your specific written consent or a court order meeting applicable Part 2 requirements.
III. Uses and Disclosures That Generally Require Your Authorization
Psychotherapy Notes
If I maintain separate psychotherapy notes as that term is defined under HIPAA, most uses or disclosures of those notes require your written authorization.
Exceptions may include certain uses or disclosures permitted or required by law, such as:
• My own use in treating you.
• Certain training or supervision activities.
• Defending myself in a legal proceeding initiated by you.
• Certain health oversight activities.
• Compliance investigations conducted by the U.S. Department of Health and Human Services.
• Uses or disclosures required by law.
• Certain duties of coroners or medical examiners.
• Certain circumstances involving a serious threat to health or safety.
Substance Use Disorder Counseling Notes
If Wildlight Counseling maintains SUD counseling notes as defined by 42 CFR Part 2, additional protections apply.
Use or disclosure of these notes generally requires separate written consent and cannot simply be combined with authorization for other types of records when applicable law requires separate consent.
You may revoke such consent as permitted by law, except to the extent action has already been taken in reliance on it.
Marketing
Wildlight Counseling will not use or disclose your PHI for marketing purposes when your authorization is required by law unless you have provided the required authorization.
Sale of PHI
Wildlight Counseling does not sell your PHI in the ordinary course of business.
IV. Uses and Disclosures That May Not Require Your Authorization
Subject to applicable federal, state, and territorial laws, Wildlight Counseling may use or disclose PHI without your authorization in certain circumstances, including:
When disclosure is required by law.
For certain public health and safety activities.
To make legally required reports concerning suspected abuse or neglect.
For certain health oversight activities, including authorized audits and investigations.
For certain judicial or administrative proceedings when applicable legal requirements have been satisfied.
For certain law enforcement purposes when permitted or required by law.
To coroners or medical examiners when authorized by law.
For certain legally authorized research activities.
For certain specialized government functions.
For workers' compensation or similar programs when permitted or required by law.
To contact you regarding appointments, treatment alternatives, or other healthcare services when permitted by law.
More protective federal, state, or territorial confidentiality laws will apply when they provide greater protection than HIPAA.
V. Uses and Disclosures Where You May Have an Opportunity to Agree or Object
People Involved in Your Care
When permitted by law, Wildlight Counseling may share relevant PHI with a family member, friend, or another person involved in your care or payment for your care.
When appropriate, you will be given an opportunity to agree or object.
In emergencies or other circumstances permitted by law, obtaining your agreement beforehand may not always be possible.
Fundraising
Wildlight Counseling does not currently use client PHI for fundraising activities.
If that practice changes, any use of PHI for fundraising will comply with applicable law, including any required opportunity for you to opt out.
Additional protections apply to fundraising communications involving records protected by 42 CFR Part 2.
VI. Your Rights Regarding Your Health Information
1. Request Restrictions
You may ask Wildlight Counseling not to use or disclose certain PHI for treatment, payment, or healthcare operations.
Wildlight Counseling is not always required to agree to your request.
2. Restrict Disclosure to a Health Plan When You Pay in Full
If you pay out of pocket in full for a particular healthcare service, you may request that PHI relating solely to that service not be disclosed to your health plan for payment or healthcare operations purposes.
When the requirements of applicable law are met, Wildlight Counseling will honor that restriction.
3. Request Confidential Communications
You may ask Wildlight Counseling to communicate with you in a particular way or at a particular location.
Reasonable requests will be accommodated as required by law.
4. Access Your Health Information
You generally have the right to inspect or obtain an electronic or paper copy of PHI maintained about you, subject to limitations permitted by law.
Certain records, including psychotherapy notes and SUD counseling notes as legally defined, may be subject to different access rules.
When you have a right to receive records, they will be provided within the timeframe required by applicable law. A reasonable, cost-based fee may be charged when permitted.
5. Request an Accounting of Disclosures
You may request a list of certain disclosures Wildlight Counseling has made of your PHI.
The accounting will cover the period and types of disclosures required by applicable law.
Additional accounting rights may apply to records protected by 42 CFR Part 2.
6. Request an Amendment
If you believe PHI maintained by Wildlight Counseling is incorrect or incomplete, you may request an amendment.
Wildlight Counseling may deny the request under circumstances permitted by law. If a request is denied, you will receive information regarding the denial and applicable rights.
7. Obtain a Copy of This Notice
You may request a paper or electronic copy of this Notice at any time.
You may request a paper copy even if you previously agreed to receive the Notice electronically.
8. Choose Someone to Act for You
If another person has legal authority to act on your behalf regarding your health information, Wildlight Counseling will recognize that authority as required by law after appropriately verifying it.
9. File a Privacy Complaint
If you believe your privacy rights have been violated, you may raise the concern directly with Wildlight Counseling.
You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights.
Wildlight Counseling will not retaliate against you for filing a complaint or exercising your privacy rights.
Information about filing a federal privacy complaint is available from the U.S. Department of Health and Human Services.
VII. Additional Protections for Mental Health & Substance Use Disorder Information
Mental health information may receive protections under state or territorial law that are greater than those provided by HIPAA.
When a more protective law applies to your information, Wildlight Counseling will follow the more protective requirement.
Similarly, if Wildlight Counseling creates, maintains, or receives records protected by 42 CFR Part 2, those records will receive the additional protections required by federal law.
In particular, Part 2 places significant restrictions on using SUD patient records in legal proceedings against the patient without the patient's specific consent or an appropriate court order and other required legal process.
VIII. Wildlight Counseling's Responsibilities
Wildlight Counseling is committed to protecting the privacy and security of your health information.
Wildlight Counseling will:
• Follow applicable privacy and confidentiality laws.
• Follow the duties and privacy practices described in the Notice currently in effect.
• Provide you with a copy of this Notice.
• Notify you if a breach occurs that may have compromised the privacy or security of your information when notification is required by law.
• Not use or disclose your PHI in ways requiring authorization unless you have provided that authorization.
If you provide an authorization, you may generally revoke it in writing as permitted by law. Revocation does not undo actions already taken in reliance on a valid authorization.
IX. Changes to This Notice
Wildlight Counseling may revise this Notice when privacy practices or applicable legal requirements change.
A revised Notice may apply to PHI already maintained as well as information received in the future.
The current version will be available upon request and will be made available through Wildlight Counseling's website as required.
X. Questions About Your Privacy
If you have questions about this Notice, your health information, or Wildlight Counseling's privacy practices, please contact:
Chelsea Roush, MA, LPC
Wildlight Counseling
Email: chelsea@wildlightcounseling.co