Notice of Privacy Practices

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

Your Rights

You have the right to:  

• Get a copy of your therapy record.
• Correct or request amendments to your record.
• Request confidential communication.
• Ask us to limit what we share.
• Get a list of those with whom we've shared your information.
• Get a copy of this privacy notice.
• Choose someone to act for you
• File a complaint if you believe your privacy rights have been violated. 

Your Choices

You have some choices in the way we use and share your information. For example, you may:  

• Decide whether to allow us to share information with family, close friends, or others involved in your care.
• Request that we do not share your information for marketing or fundraising purposes.
• Opt out of receiving appointment reminders through certain methods (e.g., text, voicemail, or email). 

Our Uses and Disclosures

We may use and share your information in the following ways:  

Treatment

We may use your health information to provide, coordinate, or manage your treatment. We may share it with other healthcare providers involved in your care, such as your primary care doctor or psychiatrist, if necessary.  

Payment 

We may use and disclose your information to obtain payment from insurance companies, third-party payers, or for billing purposes.

Healthcare Operations  

We may use your information for internal operations such as improving the quality of care, staff training, and administrative functions.

Legal Requirements & Public Health 

We may disclose your health information if required by law or for public health and safety purposes, such as: 

• Reporting suspected abuse, neglect, or domestic violence.
• Preventing or reducing a serious threat to your safety or the safety of others.
• Complying with legal requests, court orders, or subpoenas.  

Other Uses Requiring Written Authorization

Any other use or sharing of your information not covered by this notice will require your written permission. You can revoke this authorization at any time in writing.  

Confidentiality & Electronic Communication

• We take reasonable steps to secure electronic communication; however, emails and texts may not be fully secure.
• If you choose to communicate via email or text, you acknowledge and accept the potential privacy risks.  

Your Access to Records

• You may request a copy of your therapy records. In some cases, a summary may be provided instead of full documentation.
• Requests must be made in writing. Fees may apply for copies.
• If access is denied due to potential harm, you may request a review of the decision.  

Filing a Complaint

If you believe your privacy rights have been violated, you may file a complaint:  

• With Our Office: Contact 48 Dietz Street Suite B,Oneonta, New York 13820 
• With the U.S. Department of Health & Human Services: Visit www.hhs.gov/hipaa or call 1-800-368-1019. 

You will not be retaliated against for filing a complaint. 

Use and Disclosure of Substance Use Disorder Records Subject to 42 CFR Part2:

If applicable, your substance use disorder ("SUD") records are protectedby federal law under 42 C.F.R. Part 2 ("Part 2"). This law provides extraconfidentiality protections and requires a separate patient consent for the useand disclosure of SUD counseling notes. Each disclosure made with patientconsent must include a copy of the consent or a clear explanation of the scope ofthe consent. It must also be accompanied by a written notice containing thelanguage in 42 CFR Part 2.32(a). Disclosure of these records requires your explicitwritten consent, except in limited circumstances such as: (a) MedicalEmergencies: to the extent necessary to treat you, (b) Reporting Crimes onProgram Premises, (c) Child Abuse Reporting: In connection with incidents ofsuspected child abuse or neglect to appropriate state or local authorities, and(d) Fundraising: We will provide you with an opportunity to decline to receiveany fundraising communications prior to making such communications.You may revoke this consent at any time.  

Prohibitions on Use and Disclosure of Part 2 Records:

SUD records received from programs subject to Part 2, or testimony relaying thecontent of such records, shall not be used or disclosed in civil, criminal,administrative, or legislative proceedings against you unless basedon your written consent, or a court order after notice and an opportunity to beheard is provided to you or the holder of the record, as provided in Part 2. A courtorder authorizing use or disclosure must be accompanied by a subpoena or otherlegal requirement compelling disclosure before the requested SUD record is usedor disclosed.  

If SUD records are disclosed to us or our business associates pursuant to yourwritten consent for treatment, payment, and healthcare operations, we or ourbusiness associates may further use and disclose such health information withoutyour written consent to the extent that the HIPAA regulations permit such usesand disclosures, consistent with the other provisions in this Notice regardingPHI. 

Acknowledgment of Receipt

I acknowledge that I have received and reviewed the Notice of Privacy Practices for Sunshine Counseling Services LCSW, PLLC.

Sunshine Counseling Services LCSW, PLLC (Owner- Tonya DeMulder, LCSWR) info@sunshinecounselingny.com or 607-287-4670.

This Notice is effective on 2/16/2026