This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review this notice carefully. 

Your health record contains personal information about you and your health. This information about you that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services is referred to as Protected Health Information (“PHI”). This Notice of Privacy Practices describes how we may use and disclose your PHI in accordance with applicable federal law, including, but not limited to, the Health Insurance Portability and Accountability Act (“HIPAA”), regulations promulgated under HIPAA including, 45 CFR Part 160 and Part 164, 42 CFR Part 2, and Illinois state law relating to confidentiality. It also describes your rights regarding how you may gain access to and control your PHI.

We are required by law to maintain the privacy of PHI and to provide you with notice of our legal duties and privacy practices with respect to PHI. We are required to abide by the terms of this Notice of Privacy Practices. We must notify affected individuals following a breach of unsecured PHI. We reserve the right to change the terms of our Notice of Privacy Practices at any time. Any new Notice of Privacy Practices will be effective for all PHI that we maintain at that time. We will provide you with a copy of the revised Notice of Privacy Practices by posting a copy on our website, sending a copy to you in the mail upon request or providing one to you at your next appointment.

HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU

For Treatment.  Your PHI may be used and disclosed by those who are involved in your care for the purpose of providing, coordinating, or managing your health care treatment and related services. This includes consultation with clinical supervisors or other treatment team members. We may disclose PHI to another health care provider that has a treatment relationship with you for the purposes of such treatment.

For Payment.  We may use and disclose PHI so that we can receive payment for the treatment services provided to you. Examples of payment-related activities are: making a determination of eligibility or coverage for insurance benefits, processing claims with your insurance company or other third-party payor, reviewing services provided to you to determine medical necessity, or undertaking utilization review activities. If it becomes necessary to use collection processes due to lack of payment for services, we will only disclose the minimum amount of PHI necessary for purposes of collection. 

For Health Care Operations.  We may use or disclose, as needed, your PHI in order to support our business activities including, but not limited to, quality assessment activities, employee review activities, licensing, and conducting or arranging for other business activities. For example, we may share your PHI with third parties that perform various business activities (e.g., billing or typing services) provided we have a written contract with the business that requires it to safeguard the privacy of your PHI.  

Required by Law.  As required by law, including that we will disclose your PHI to you upon your request unless a limited exception applies. In addition, we must make disclosures to the Secretary of the Department of Health and Human Services for the purpose of investigating or determining our compliance with the requirements of the Privacy Rule.

Without Authorization.  Applicable law and ethical standards permit us to disclose information about you without your authorization in a limited number of other situations. The types of uses and disclosures that may be made without your authorization include, but are not limited to, those that are:

• As required by law, such as the mandatory reporting of abuse or neglect of a child, an adult with disabilities, or an elderly person, or in cooperation with mandatory government agency audits or investigations (such as the licensing board or the health department) 

• As required by subpoena or court order or other judicial and administrative proceedings

• When necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. If information is disclosed to prevent or lessen a serious threat it may be disclosed to a person or persons reasonably able to prevent or lessen the threat, including a target of the threat.

• When necessary for the provision of emergency medical care

• When necessary to initiate or continue civil commitment or involuntary treatment proceedings

• To an attorney regarding our legal duties in relation to the services being provided

• As required by law to law enforcement, for example, crime on premises

• As otherwise required or permitted by law.

In some circumstances, PHI which is disclosed pursuant to the HIPAA Privacy Rule may be subject to redisclosure by the recipient of the PHI, and will no longer be protected by those regulations.

With Authorization.   Uses and disclosures not specifically permitted by applicable law will be made only with your written authorization, which may be revoked, in writing, at any time except to the extent that we have already made a use or disclosure based upon your authorization. The following uses and disclosures are examples of those that will be made only with your written authorization: (i) most uses and disclosures of psychotherapy notes which are separated from the rest of your medical record; (ii) most uses and disclosures of PHI for marketing purposes, including subsidized treatment communications; (iii) disclosures that constitute a sale of PHI; and (iv) other uses and disclosures not described in this Notice of Privacy Practices.

SUD (Substance Use Disorder) Treatment Information. Any use or disclosure of SUD records will generally require your written consent. If we receive or maintain any information about you from a SUD treatment program that is covered by 42 CFR Part 2 (a “Part 2 Program”) through a general consent you provide to use and disclose your information for purposes of treatment, payment or health care operations, we may use and disclose your Part 2 Program record for such purposes as described in this Notice. If we receive or maintain your Part 2 Program record through a specific consent you provide to us or another third party, we will use and disclose your Part 2 Program record only as permitted by such consent.

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 expressly authorized by your consent or the order of a court after notice and an opportunity to be heard. A court order authorizing such use or disclosure must be accompanied by a subpoena or other legal process compelling disclosure before the requested record is used or disclosed.

YOUR RIGHTS REGARDING YOUR PHI

You have the following rights regarding PHI we maintain about you. To exercise any of these rights, please submit your request in writing to our Privacy Officer at info@catalyst-therapy.com:

• Right of Access to Inspect and Copy.  You have the right, which may be restricted only in certain specific circumstances, to inspect and copy PHI that is maintained in a “designated record set.” A designated record set contains mental health/medical and billing records and any other records that are used to make decisions about your care. We may charge a reasonable, cost-based fee for copies. If your records are maintained electronically, you may also request an electronic copy of your PHI.  You may also request that a copy of your PHI be provided to another person.

• Right to Amend.  If you feel that your PHI is incorrect or incomplete, you may ask us to amend the information although we are not required to agree to the amendment. If we deny your request for amendment, you have the right to file a statement of disagreement with us. We may prepare a rebuttal to your statement and will provide you with a copy. Please contact the Privacy Officer if you have any questions.

• Right to an Accounting of Disclosures.  You have the right to request an accounting of certain of the disclosures that we make of your PHI. We may charge you a reasonable fee if you request more than one accounting in any 12-month period.

• Right to Request Restrictions.  You have the right to request a restriction or limitation on the use or disclosure of your PHI for treatment, payment, or health care operations. We are not required to agree to your request unless the request is to restrict disclosure of PHI to a health plan for purposes of carrying out payment or health care operations, and the PHI pertains to a health care item or service that you paid for out of pocket. In that case, we are required to honor your request for a restriction. 

• Right to Request Confidential Communication.  You have the right to request that we communicate with you about health matters in a certain way or at a certain location. We will accommodate reasonable requests. We may require information regarding how payment will be handled or specification of an alternative address or other method of contact as a condition for accommodating your request. We will not ask you for an explanation of why you are making the request.

• Breach Notification. If there is a breach of unsecured PHI concerning you, we may be required to notify you of this breach, including what happened and what you can do to protect yourself.

• Right to a Copy of this Notice.  You have the right to a copy of this notice, including a paper copy if requested.

COMPLAINTS

If you believe we have violated your privacy rights, you have the right to file a complaint in writing with our Privacy Officer at Catalyst Therapy & Consulting PLLC, (224) 339-4921, or with the Secretary of Health and Human Services at 200 Independence Avenue, S.W.  Washington, D.C. 20201 or by calling (202) 619-0257. We will not retaliate against you for filing a complaint. 

The effective date of this Notice is 02/16/2026