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Notice of Privacy Practices

501 S. Cherry St., Suite 1100 

Denver, CO 80246 

720-547-8388 

THIS NOTICE DESCRIBES HOW MENTAL HEALTH AND MEDICAL INFORMATION  ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO  THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. 

In the course of providing services to you, SideDoor Counseling, LLC (“SideDoor Counseling”)  will obtain, record, and use mental health and medical information about you that is considered  Protected Health Information, or “PHI.” PHI is defined as “individually identifiable health  information” that is created or received by a healthcare provider and which relates to past, present,  or future health, provision of healthcare, or payment for provision of healthcare and that either  identifies the individual or could be used to identify the individual. HIPAA and other lawsregulate the use and disclosure of PHI when it is transmitted electronically. This Notice describes SideDoor  Counseling’s policies related to the use and disclosure of your PHI. 

Please note that information disclosed under HIPAA may be subject to redisclosure by the recipient  and therefore lose its protection. 

Uses and Disclosures Not Requiring Consent

Providing treatment services, collecting payment and conducting healthcare operations are  necessary activities for quality care. State and federal laws allow me to use and disclose your  health information for these purposes. In most cases, I am limited to disclosing the minimum  information necessary to accomplish these purposes. To help clarify these terms, here are some  examples: 

  • Treatment is when I use and disclose health information to provide, coordinate or manage  your health care and other services related to your health care. If I decide to consult with another  licensed health care provider about your condition, I would be permitted to use and disclose your  personal health information, which is otherwise confidential, in order to assist me in the diagnosis  or treatment of your mental health condition. 

Disclosures for treatment purposes are not limited to the minimum necessary standard, because  physicians and other health care providers need access to the full record and/or full and complete  information in order to provide quality care. The word “treatment” includes, among other things,  the coordination and management of health care among health care providers or by a health care  provider with a third party, consultations between health care providers, and referrals of a patient  for health care from one health care provider to another.

  • Payment is when I use and disclose health information to obtain reimbursement for your  healthcare. Examples of payment are when I disclose your PHI to your health insurer to obtain  reimbursement for your health care or to determine eligibility or coverage. 
  • Health Care Operations refers to the use and disclosure of health information for activities  that relate to the performance and operation of my practice. Examples of health care operations  are review of treatment procedures or business operations, quality assessment and improvement  activities, and staff training. 

PLEASE NOTE: I, or someone from SideDoor Counseling acting with my authority, may contact  you to provide appointment reminders or information about treatment alternatives or other health related benefits and services that may be of interest to you. Your prior written authorization is not  required for such contact. 

SUD Treatment Information. Unlike standard protected health information (PHI), substance use  disorder records generally require your written consent to be used for treatment, payment, or  healthcare operations. If we receive or maintain any information about you from a substance use  disorder treatment program that is covered by 42 CFR Part 2 (a “Part 2 Program”) through a general  consent you provide to the Part 2 Program to use and disclose the Part 2 Program record for  purposes of treatment, payment or health care operations, we may use and disclose your Part 2  Program record for treatment, payment and health care operations purposes as described in this  Notice. If we receive or maintain your Part 2 Program record through specific consent you provide  to us or another third party, we will use and disclose your Part 2 Program record only as expressly  permitted by you in your consent as provided to us. 

In no event will we use or disclose your Part 2 Program record, or testimony that describes the  information contained in your Part 2 Program record, in any civil, criminal, administrative, or  legislative proceedings by any Federal, State, or local authority, against you, unless authorized by  your consent or the order of a court after it provides you notice of the court order; any such court  order must be accompanied by a subpoena or other legal requirement compelling disclosure. 

Uses and Disclosures Requiring Authorization 

I may use or disclose PHI for purposes outside of treatment, payment, or health care operations  when your appropriate authorization is obtained. In those instances when I am asked for information for purposes outside of treatment, payment or health care operations, I will obtain an authorization from you before releasing thisinformation. I will also need to obtain an authorization before releasing your Psychotherapy Notes. “Psychotherapy Notes” are notes I have made about our conversation during a private, group, joint, or family counseling session, which I have kept  separate from the rest of your medical record. These notes are given a greater degree of protection  than PHI. I will also obtain an authorization from you before using or disclosing PHI in a way that  is not described in this Notice. You may revoke all such authorizations at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) I have relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, law provides  the insurer the right to contest the claim under the policy.

Uses and Disclosures with Neither Consent nor Authorization 

I may use or disclose PHI without your consent or authorization in certain circumstances,  including, but not limited to: 

  • Child or At-Risk Adult Abuse: If I have reasonable cause to know or suspect that a child  has been subjected to abuse or neglect or an at-risk adult has been mistreated, self-neglected, or  financially exploited or is at imminent risk of mistreatment, self-neglect, or financial exploitation,  then I must report this to the appropriate authorities. 
  • Health Oversight Activities: If the Colorado state licensing board or an authorized  professional review committee is reviewing my services, I may disclose PHI to that board or  committee. 
  • Judicial and Administrative Proceedings: If you are involved in a court proceeding where  you are being evaluated for a third party or where the evaluation is court ordered, I may disclose  PHI to the court. You will be informed in advance if this is the case. 
  • Serious Threat to Health or Safety: If you communicate to me a serious threat of imminent  physical violence against a specific person or persons, including those identifiable by association  with a specific place, I have a duty to notify any person or persons specifically threatened, as well  as a duty to protect by taking other appropriate action. If I believe that you are at imminent risk  of inflicting serious harm on yourself, I may disclose information necessary to protect you. In  either case, I may disclose information in order to initiate hospitalization. 
  • Business Associates: SideDoor Counseling may enter into contracts with business  associates to provide billing, legal, auditing, and practice management services that are outside  entities. In those situations, protected health information will be provided to those contractors as  is needed to perform their contracted tasks. Business associates are required to enter into an  agreement maintaining the privacy of the protected health information released to them. 
  • In Compliance with Other State/Federal Laws and Regulations: PHI may be disclosed  when the use and disclosure is allowed under other sections of Section 164.512 of the Privacy Rule  and the state’s confidentiality law. This includes certain narrowly-defined disclosures to law  enforcement agencies, to a health oversight agency (such as HHS), to a medical examiner, for  public health purposes relating to disease or FDA-regulated products, or for specialized  government functions (fitness for military duties, eligibility for VA benefits, etc.) 

Client Rights 

When it comes to your PHI, you have certain rights. This section explains your rights and some  of SideDoor Counseling’s responsibilities to help you. 

  • Right to Request Restrictions: You have the right to request restrictions on certain uses and  disclosures of protected health information regarding you. The request must be in writing, and I  am not required to agree to a restriction you request. 
  • Right to Receive Confidential Communications by Alternative Means and at Alternative  Locations: You have the right to request and receive confidential communications of PHI by  alternative means and at alternative locations. (For example, you may not want a family member to know that you are seeing me. On your request, I will send your bills to another address.) 
  • Right to Inspect and Copy: You have the right to inspect or obtain a copy (or both) of PHI  in my mental health and billing records used to make decisions about you for as long as the PHI is  maintained in the record. I may deny your access to PHI under certain circumstances, but in some  cases you may have this decision reviewed. On your request, I will discuss with you the details of  the request and denial process. 
  • Right to Amend: You have the right to request an amendment of PHI for as long as the PHI  is maintained in the record. I may deny your request. On your request, I will discuss with you the  details of the amendment process. 
  • Right to an Accounting: You generally have the right to receive an accounting of  disclosures of PHI. On your request, I will discuss with you the details of the accounting process. • Right to a Paper Copy: You have the right to obtain a paper copy of the notice from me  upon request, even if you have agreed to receive the notice electronically. 
  • Right to Restrict Disclosures When You Have Paid for Your Care Out-of-Pocket: You have  the right to restrict certain disclosures of PHI to a health plan when you pay out-of-pocket in full  for my services. 

Provider’s Duties 

As a mental health provider, I have certain duties to you related to your PHI. These are described  below. 

  • I am required by law to maintain the privacy of PHI and to provide you with a notice of  my legal duties and privacy practices with respect to PHI. 
  • I am required to notify you if: (a) there is a breach (a use or disclosure of your PHI in  violation of the HIPAA Privacy Rule) involving your PHI; (b) that PHI has not been encrypted to  government standards; and (c) my risk assessment fails to determine that there is a low probability  that your PHI has been compromised. 
  • I reserve the right to change the privacy policies and practices described in this notice.  Unless I notify you of such changes, however, I am required to abide by the terms currently in  effect. 
  • If I revise my policies and procedures, I will send a revised Notice of Privacy Practices by  mail or email to the address I have in your record. 

Questions and Complaints 

If you have questions about this notice, disagree with a decision I make about access to your  records, or have other concerns about your privacy rights, you may contact the Privacy Officer,  Sarah Malone, LPC at 720-547-8388 or by mail at 501 S Cherry St., Ste 1100, Denver CO 80246.

If you believe that your privacy rights have been violated and wish to file a complaint with my  office, you may send your written complaint to Sarah Malone, LPC, at 501 S Cherry St., Ste 1100,  Denver CO 80246. 

You may also send a written complaint to the Secretary of the U.S. Department of Health and Human Services. Centralized Case Management Operations, U.S. Department of Health and  Human Services, 200 Independence Avenue, S.W., Room 509F HHH Bldg., Washington, D.C. 20201, or email to OCRComplaint@hhs.gov. SideDoor Counseling will not retaliate against you  for exercising your right to file a complaint. 

This Notice is effective February 2026. 

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html