Notice of Privacy Practices

YOUR RIGHTS

Your rights regarding PHI are explained below. To exercise these rights, please submit a written request to the Practice using the contact information provided in this Notice.

To inspect and obtain a copy of PHI.

• You may ask to see or obtain an electronic or paper copy of your health information. The Practice will provide a copy or summary of your health information, usually within 30 days of your request, as required by law.

• The Practice may charge a reasonable, cost-based fee as permitted by law.

• In certain limited circumstances, the Practice may deny access to some or all of the requested information. When applicable, you may have the right to request review of that decision.

To request an amendment to PHI.

• You may ask the Practice to correct health information that you believe is incorrect or incomplete.

• The Practice may require that your request be made in writing and that you provide a reason for the requested amendment.

• The Practice may deny your request in certain circumstances. If the request is denied, the Practice will provide a written explanation and inform you of any rights you have to submit a written statement of disagreement.

To request confidential communications.

• You may ask the Practice to contact you in a specific way or at a specific location.

• The Practice will accommodate reasonable requests.

To request restrictions on what is used or disclosed.

• You may ask the Practice not to use or disclose certain PHI for treatment, payment, or health care operations. The Practice is generally not required to agree to your request.

• If you pay for a health care service or item out-of-pocket in full, you may ask the Practice not to disclose information about that service or item to your health plan for payment or health care operations purposes. The Practice will honor the request when required by law.

• You may ask the Practice to limit disclosures of your PHI to family members, friends, or others involved in your care by identifying the restriction requested and the person or persons to whom you want the restriction to apply.

To obtain an accounting of certain disclosures.

• You may request an accounting of certain disclosures of your PHI made during the six years prior to the date of your request, including information about who received the information and the purpose of the disclosure.

• Certain disclosures are not required to be included in an accounting, including many disclosures made for treatment, payment, or health care operations.

• The Practice will provide one accounting during a 12-month period at no charge. The Practice may charge a reasonable, cost-based fee for additional requests during the same 12-month period as permitted by law.

To receive a copy of this Notice.

• You may request a paper copy of this Notice at any time, even if you previously agreed to receive the Notice electronically.

To choose someone to act for you.

• If you have given someone medical power of attorney, if someone is your legal guardian, or if another person is legally authorized to act on your behalf, that person may exercise your rights and make choices about your health information as permitted by law.

• The Practice may verify that the person has appropriate legal authority before taking action.

To file a complaint if you believe your privacy rights have been violated.

• You may file a complaint directly with the Practice using the contact information below.

• You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting the HHS Office for Civil Rights website.

• The Practice will not retaliate against you for filing a complaint.

To file a complaint, exercise your rights, or ask questions about this Notice, contact:

Kindred Paws Counseling & Play Therapy, PLLC
4204 Gardendale St, Suite 108
San Antonio, TX 78229
Privacy Officer: Melanie Lawson, LCSW
Telephone: 210-716-0229

Website: www.kindredpawscounseling.com

OUR USES AND DISCLOSURES

1. Routine Uses and Disclosures of PHI

Federal law permits the Practice to use and disclose PHI without your written authorization for certain purposes, including treatment, payment, and health care operations.

Treatment

• The Practice may use and disclose PHI with other health care professionals involved in your treatment when permitted by law.

• Example: Your primary care provider requests information relevant to coordinating your care.

Health Care Operations

• The Practice may use and disclose PHI as necessary to operate the Practice, improve the quality of services, manage business activities, and contact you regarding your care.

• Example: The Practice may use PHI to provide appointment reminders or communicate with you regarding services.

Payment

• The Practice may use and disclose PHI to bill for services and obtain payment from health plans or other responsible entities.

• Example: The Practice may provide necessary information to your health insurance plan so that a claim for counseling services can be processed.

2. Uses and Disclosures That May Be Made Without Your Authorization or Opportunity to Object

The Practice may use or disclose PHI without your written authorization when permitted or required by applicable federal or state law. Examples may include:

Public health and safety

• Public health activities: For certain legally authorized public health activities, such as preventing or controlling disease or reporting information required by law.

• Health oversight: For legally authorized audits, investigations, inspections, licensing activities, or other government oversight activities.

• U.S. Department of Health and Human Services: The Practice may disclose PHI to the U.S. Department of Health and Human Services when required to demonstrate compliance with federal privacy requirements.

• Serious threat to health or safety: When permitted or required by law to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.

• Abuse, neglect, or exploitation: The Practice may make reports or disclosures concerning suspected abuse, neglect, exploitation, or family violence when required or permitted by applicable law.

Legal, law-enforcement, and governmental purposes

• Required by law: The Practice may use or disclose PHI when required by applicable federal, state, or local law.

• Judicial and administrative proceedings: The Practice may disclose PHI in response to a valid court order or other lawful legal process when disclosure is permitted or required by law.

• Law enforcement: The Practice may disclose PHI for certain law-enforcement purposes when permitted or required by applicable law.

• Specialized government functions: PHI may be disclosed for certain military, national security, intelligence, protective-service, or other specialized government functions when authorized by law.

• Workers’ compensation: PHI may be disclosed as authorized by and to the extent necessary to comply with workers’ compensation or similar programs established by law.

Other purposes permitted or required by law

• Coroners, medical examiners, and funeral directors: PHI may be disclosed as necessary for these individuals to perform duties authorized by law.

• Organ and tissue donation: PHI may be disclosed to organizations involved in organ, eye, or tissue donation and transplantation when applicable.

• Research: PHI may be used or disclosed for research when the requirements of applicable law have been satisfied, including appropriate approval or waiver when required.

• Correctional institutions and custodial situations: If you are an inmate or otherwise in lawful custody, PHI may be disclosed as permitted by law for health, safety, or institutional purposes.

• Business associates: The Practice may disclose PHI to individuals or organizations that perform functions, activities, or services on behalf of the Practice when permitted by law and subject to applicable privacy and security requirements.

3. Uses and Disclosures That May Be Made With an Opportunity to Agree or Object

Unless you object, or unless otherwise restricted by law, the Practice may disclose relevant PHI:

• To a family member, friend, caregiver, or other person involved in your care or payment for your care, when the information is directly relevant to that person's involvement; or

• When you are unable to state your preference, if the Practice determines that disclosure is in your best interest and the disclosure is otherwise permitted by law.

Disaster relief. The Practice may share relevant PHI with organizations authorized to assist in disaster-relief efforts for purposes such as helping identify, locate, or notify family members or others responsible for your care, as permitted by law. When circumstances allow, you may tell the Practice your preferences regarding these disclosures.

For minor clients or individuals with legally authorized representatives, access to and disclosure of PHI will be handled in accordance with applicable federal and Texas law and any relevant legal documentation.

4. Uses and Disclosures Requiring Written Authorization

The Practice will obtain your written authorization before using or disclosing PHI when authorization is required by law, including for:

• Most uses and disclosures of psychotherapy notes, except as otherwise permitted or required by law.

Kindred Paws does not sell your PHI or use or disclose your PHI for marketing purposes.

Other uses and disclosures of PHI not described in this Notice will be made only with your written authorization when required.

You may revoke a written authorization at any time by submitting your revocation to the Practice in writing. Revocation will not affect actions already taken in reliance on a valid authorization before the Practice received your revocation.

5. USE AND DISCLOSURE OF SUBSTANCE USE DISORDER RECORDS SUBJECT TO 42 CFR PART 2, IF APPLICABLE

If applicable, certain substance use disorder (“SUD”) records may receive additional confidentiality protections under federal law, including 42 C.F.R. Part 2 (“Part 2”).

When the Practice creates, receives, or maintains records protected by Part 2, those records will be used and disclosed in accordance with applicable federal law. Certain uses and disclosures may require your written consent, while others may be permitted or required without consent in limited circumstances authorized by law.

SUD counseling notes maintained by a Part 2 program receive additional protections, and separate consent may be required for their use or disclosure as provided by law.

Part 2 records may be disclosed without patient consent in certain circumstances permitted by law, which may include medical emergencies, certain reports of suspected child abuse or neglect, crimes committed on program premises or against program personnel, audits and evaluations, or pursuant to a qualifying court order.

Restrictions on the use of Part 2 records in legal proceedings

Records protected by Part 2, and testimony describing the contents of those records, generally may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless the requirements of Part 2 are satisfied, such as through your written consent or an appropriate court order and accompanying legal process.

When Part 2 records are disclosed pursuant to a valid consent for treatment, payment, or health care operations, the Practice and its business associates may use and redisclose the information as permitted by applicable HIPAA and Part 2 requirements.

Additional restrictions may apply to SUD counseling notes and to the use of Part 2 records in investigations or legal proceedings.

OUR RESPONSIBILITIES

• The Practice is required by law to maintain the privacy and security of your PHI.

• The Practice will notify you as required by law if a breach occurs that may have compromised the privacy or security of your PHI.

• The Practice is required to follow the duties and privacy practices described in the Notice currently in effect.

• When another applicable state or federal law provides greater privacy protection than HIPAA, the Practice will comply with the more protective applicable law.

• The Practice reserves the right to change the terms of this Notice and its privacy practices. Changes may apply to PHI already maintained by the Practice as well as PHI received or created in the future.

• If the Practice makes a material change to this Notice, the revised Notice will be made available upon request and posted as required by law.

This Notice is effective September 13, 2026.