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HIPAA Notice of Privacy Practices

This notice describes how your confidential mental health treatment information can be used and disclosed and how you can obtain access to this information in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Please review it carefully and let me if you have questions . During the process of providing services to you, Unfolding Path Counseling will obtain and use mental health and medical information about you that is both confidential and privileged. This information will be used in the manner described in this statement, and will not be disclosed without your consent, except as described in this Notice.


Uses and Disclosures not requiring client consent. Unfolding Path Counseling may use and disclose protected health information in the following ways:

a.               Treatment: Treatment refers to the provision, coordination, or management of mental health care and related services by one or more health care providers. For example, Unfolding Path Counseling may use your information to plan your course of treatment and consult with other health care professionals or their staff concerning services needed or provided to you.

b.              Payment: Payment refers to the activities undertaken by a health care provider to obtain or provide reimbursement for the provision of health care. For example, Unfolding Path Counseling will use information that identifies you, including information concerning your diagnosis, services provided to you, dates of services, and services needed by you, and may disclose such information to insurance companies, to businesses that review bills for health care services and handle claims for payment of health care benefits in order to obtain payment for services.

c.               Health Care Operations: Health Care Operations means activities undertaken by health insurance companies, businesses that administer health plans, and companies that review bills for health care services in order to process claims for health care benefits. These functions include management and administrative activities. For example, such companies may use your health information in monitoring of service quality, staff training and evaluation, medical reviews, legal services, auditing functions, compliance programs, business planning and accreditation, certification, licensing, and credentialing activities.

d.               Contacting the Client: Unfolding Path Counseling may contact you to remind you of appointments and to tell you about treatments or other services that might be of benefit to you.

e.               As Required by Law: Unfolding Path Counseling will disclose protected health information when required by law. This includes, but is not limited to: 1. Reporting child abuse or neglect to the Department of Human Services or to law enforcement. 2. When court ordered to release information. 3. When there is a legal duty to warn of a threat that a client has made of imminent physical violence, health care professionals are required to notify the potential victim of such a threat, and report it to law enforcement. 4. When a client is imminently dangerous to herself/himself or to others, or is gravely disabled, health care professionals may have a duty to hospitalize the client in order to obtain a 72-hour evaluation of the client. 5. When required to report a threat to the national security of the United States.

f.               Health Oversight Activities: Your confidential, protected health information may be disclosed to health oversight agencies for oversight activities authorized by law and necessary for the oversight of the health care system, government health care benefit programs, regulatory programs, or determining compliance with program standards.

g.              Crimes On the Premises or Observed by Unfolding Path Counseling: Crimes that are observed by Chris McKee, MA, that are directed toward staff, or occur on Unfolding Path Counseling premises will be reported to law enforcement.

h.              Business Associates: Confidential health care information concerning you, provided to insurers, or to plans for purposes of payment for services that you receive may be disclosed to business associates. For example, some administrative, clinical, quality assurance, billing, legal, auditing, and practice management services may be provided by contracting with outside entities to perform those services. 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 privacy of the protected health information released to them.

i.               Research: Protected health information concerning you may be used with your permission for research purposes if the relevant provisions of the federal HIPAA privacy regulations are followed.

j.               Involuntary Clients: Information regarding clients who are being treated involuntarily, pursuant to law, will be shared with other treatment providers, legal entities, third party payers, and others, as necessary to provide the care and management coordination needed in compliance with state law.

k.              Family Members: Except for certain minors, incompetent clients, or involuntary clients, protected health information cannot be provided to family members without the client’s consent. In situations where family members are present during a discussion with the client, and it can be reasonably inferred from the circumstances that the client does not object, information may be disclosed in the course of the discussion. However, if the client objects, protected health information will not be disclosed.

l.               Emergencies: In life-threatening emergencies, Unfolding Path Counseling will disclose information necessary to avoid serious harm or death.


a.              Access to Protected Health Information: You have the right to receive a summary of confidential health information concerning you with regard to mental health services needed or provided to you. There are some limitations to this right, which will be provided to you at the time of your request, if any such limitation applies.

b.              Correction of Your Record: You have the right to request Unfolding Path Counseling or your health care professionals amend your protected health information. Unfolding Path Counseling is not required to amend the record if it is determined that the record is accurate and complete. If your request is denied, Unfolding Path Counseling will explain the reasons why in writing within 60 days.

c.               Accounting of Disclosures: You have the right to receive an accounting of certain disclosures Unfolding Path Counseling has made regarding your protected health information. However, that accounting does not include disclosures that were made for the purpose of treatment, payment, or health care operations. In addition, the accounting does not include disclosures made to you, disclosures made pursuant to a signed authorization, or disclosures made prior to April 14, 2003. There are other exceptions that will be provided to you, should you request an accounting.

d.              Additional Restrictions: You have the right to request additional restrictions on the use or disclosure of your health information. Unfolding Path Counseling does not have to agree to that request, and there are certain limits to any restriction, which will be provided to you at the time of your request.

e.               Request Confidential Communications: You have the right to request that you receive communications of protected health information from Unfolding Path Counseling by alternative means or at alternative locations. For example, if you do not want bills or other materials mailed to your home, you can request that this information be sent to another address. There may be limitations to the granting of such requests.

f.               Choose someone to act for you. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

g.              Copy of This Notice: You have a right to receive another copy of this notice upon request.

h.              File a Complaint: If you believe your rights have been violated, you have the right to complain to Unfolding Path Counseling. Please submit a statement, in writing, concerning your complaint and the basis for it to the following:

Unfolding Path Counseling, PLLC

123 S Broad St, Suite 2015

Philadelphia, PA 19109

You also have the right to complain to the United States Secretary of Health and Human Services by sending your complaint to:

US Department of Health and Human Services

ATTN: Office of Civil Rights 200 Independence Avenue SW Room 515F

HHH Building Washington DC 20201


There will be no retaliation for filing a complaint.


a.              Privacy Laws: Unfolding Path Counseling is required by state and federal law to maintain the privacy of protected health information. In addition, Unfolding Path Counseling is required by law to provide clients with notice of its legal duties and privacy practices with respect to protected health information. That is the purpose of this notice.

b.              Terms of the Notice and Changes to the Notice: Unfolding Path Counseling is required to abide by the terms of this notice, or any amended notice that may follow. Unfolding Path Counseling reserves the right to change the terms of its notice and to make the new notice provisions effective for all protected health information that it maintains. When the notice is revised, the revised notice will be posted in service delivery sites and will be available upon request.

c.               Security Breaches: We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

d.              Client Release of Information or Authorization: Unfolding Path Counseling and other health care professionals may not use or disclose protected health information in any way without a signed release of information or authorization. When you sign a release of information or an authorization, it may later be revoked, provided that the revocation is in writing. The revocation will apply, except to the extent Unfolding Path Counseling has already taken action in reliance thereon.


a.              The confidentiality of alcohol and drug abuse patient records maintained by Unfolding Path Counselng is protected by federal law and regulations. Generally, Unfolding Path Counseling may not say to a person outside the organization that the client is attending counseling, or disclose any information identifying a patient as an alcohol or drug abuser unless:

i.        The patient consents in writing.

ii.       The disclosure is allowed by a court order.

iii.     The disclosure is made to medical personnel in a medical emergency or to other qualified personnel for research, audit, or program evaluation.

b.              Violation of the Federal Law and Regulations by a Program is a Crime: Suspected violations may be reported to appropriate authorities in accordance with federal regulations.

c.               Federal law and regulations do not protect any information about a crime committed by a patient either at the program or against any person who works for the program or about any threat to commit such a crime. Disclosure may be made concerning any threat made by a client to commit imminent physical violence against another person to the potential victim who has been threatened and to law enforcement. d. Federal law and regulations do not protect any information about suspected child abuse or neglect from being reported under state law to appropriate state or local authorities.


a.              This notice is effective Feb 1, 2018.

b.              If you require additional information regarding this notice, you may contact the owner of Unfolding Path Counseling, Chris McKee, MA, LPC at or 303-506-9870

c.               We never disclose or sell personal information for marketing purposes.

I have read the preceding information and understand these disclosures. I have received a copy of this Notice of Privacy Policies and agree to the aforementioned terms.