Understanding Your Health Information Rights
As a client of Lefkowich Counseling LLC, you have the right to:
Access and Inspect Your Records: You may request to see or obtain a copy of your health records, with certain exceptions.
Request Amendments: If you believe the information in your record is incorrect, you can request an amendment.
Request Confidential Communications: You may ask that we communicate with you in a specific way (e.g., using a different phone number).
Request Restrictions: You may request limitations on the information we disclose about you, although we are not required to agree to these requests.
Receive a List of Disclosures: You have the right to request a record of certain disclosures we made of your health information.
2. How We Use and Disclose Your Health Information
Your health information is private, and we are committed to protecting it. However, under certain circumstances, we may use or disclose your information without your explicit consent:
For Treatment
We may use your health information to provide, coordinate, and manage your care and related services. For example, we may disclose information to another health provider involved in your care.
For Payment
Since you are paying privately, this disclosure may not apply, but if billing information is needed in the future (e.g., payment arrangements, collections), your information may be used accordingly.
For Health Care Operations
We may use your information to ensure the quality and effectiveness of our services, conduct audits, or train our staff.
For Public Health and Safety
We may disclose health information for public health activities, such as reporting communicable diseases, to prevent or control disease, injury, or disability.
When Required by Law
We may disclose information when required by federal, state, or local law, such as during a court order, subpoena, or for law enforcement purposes.
To Avoid Harm
If you express a credible threat of serious harm to yourself or others, we may disclose information to prevent that harm.
In Case of Abuse or Neglect
We are required by law to report suspected cases of child, elder, or vulnerable adult abuse or neglect.
3. Other Uses of Your Health Information
Other uses and disclosures of your health information will be made only with your written authorization. You may revoke your authorization in writing at any time, except to the extent that action has already been taken.
4. Your Choices Regarding Your Health Information
In certain cases, you can ask us to:
Restrict our use or disclosure of your information
Communicate with you about your health in specific ways (e.g., contacting you at a certain phone number)
Share information with family members or others involved in your care only when you authorize us to do so
5. Lefkowich Counseling LLC is required by law to:
Keep your health information private and secure.
Inform you if there is a breach of your unsecured health information.
Provide you with a copy of this notice.
Follow the practices outlined in this notice unless changes are made, in which case, a new notice will be available to you.
6. Changes to This Notice
We reserve the right to change this notice at any time. Any changes will apply to information we already hold, as well as new information received after the change occurs. A current copy of the notice will be available at all times, and the effective date will be noted at the top.
7. Questions and Complaints
If you believe your privacy rights have been violated or if you have questions about this notice, you may file a complaint with us or with the U.S. Department of Health and Human Services. There will be no retaliation for filing a complaint.
To file a complaint with BBHT, complete complaint form:
https://mn.gov/boards/behavioral-health/public-information/complaints-discipline.jsp
To file a complaint with the U.S. Department of Health and Human Services:
Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Phone: 1-877-696-6775