Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Resilient Minds PLLC (the “Practice”) is committed to protecting your privacy. We are required by federal law to maintain the privacy of your Protected Health Information (“PHI”), which includes information that identifies you or could reasonably be used to identify you.
We are also required to provide you with this Notice of Privacy Practices (“Notice”), which explains:
Our legal duties and privacy practices
How we may use and disclose your PHI
Your rights regarding your PHI
YOUR RIGHTS
You have the following rights regarding your Protected Health Information. To exercise any of these rights, submit a written request to:
Resilient Minds PLLC
18635 I-10
Vidor, TX 77662
409-238-2244
1. Right to Inspect and Copy PHI
You may request an electronic or paper copy of your PHI.
A reasonable fee may apply.
We may deny your request if disclosure could endanger you or another person. You may request a review of that decision.
2. Right to Amend PHI
You may request corrections to PHI you believe is incorrect or incomplete.
Requests must be made in writing and include a reason.
If denied, you will receive a written explanation and may submit a statement of disagreement.
3. Right to Request Confidential Communications
You may request that we contact you in a specific way (e.g., only by cell phone or at work).
We will accommodate all reasonable requests.
4. Right to Request Restrictions
You may request that we limit how we use or disclose your PHI for:
Treatment
Payment
Health care operations
We are not required to agree if it affects your care.
If you pay in full out-of-pocket for a service, you may request that we not disclose related PHI to your health insurer.
You may also request that we not share information with specific family members or others involved in your care.
5. Right to an Accounting of Disclosures
You may request a list of disclosures made in the past six years.
One free accounting per 12 months.
A reasonable fee may apply for additional requests.
6. Right to a Paper Copy of This Notice
You may request a paper copy at any time, even if you agreed to receive it electronically.
7. Right to Choose Someone to Act for You
If you have a medical power of attorney or legal guardian, that individual may exercise your rights.
8. Right to File a Complaint
If you believe your rights have been violated:
You may contact:
Resilient Minds PLLC
409-238-2244
Or file a complaint with:
U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
1-877-696-6775
www.hhs.gov/ocr/privacy/hipaa/complaints/
We will not retaliate against you for filing a complaint.
9. Right to Opt Out of Fundraising Communications
We may contact you for fundraising efforts. You may opt out at any time.
OUR USES AND DISCLOSURES
1. Routine Uses and Disclosures (No Authorization Required)
We may use or share your PHI for:
Treatment
To coordinate your care with other professionals.
Example: Communicating with your primary care provider.
Payment
To bill and receive payment from insurance companies or other entities.
Health Care Operations
To operate our business, improve care, conduct quality assessments, and contact you for appointment reminders.
2. Disclosures Without Authorization or Opportunity to Object
We may disclose PHI without your authorization in situations including:
Public Health and Safety
Preventing disease spread
Reporting adverse medication reactions
Assisting with recalls
Health Oversight
Audits, inspections, investigations by regulatory agencies.
Abuse, Neglect, or Domestic Violence
When required by law.
Serious Threat to Health or Safety
To prevent imminent harm.
Required by Law
Court orders, subpoenas, law enforcement requests.
Specialized Government Functions
Military, national security, protective services.
Workers’ Compensation
To comply with related laws.
Coroners and Funeral Directors
For legally authorized duties.
Organ Donation
For donation or transplantation.
Research
When approved by an Institutional Review Board (IRB).
Business Associates
Organizations that perform services on our behalf under confidentiality agreements.
3. Disclosures With Opportunity to Object
Unless you object, we may disclose PHI:
To family members or others involved in your care
When in your best interest if you are unable to express your preference
4. Uses Requiring Written Authorization
We must obtain your written authorization for:
Marketing
Sale of PHI
Psychotherapy notes
You may revoke authorization at any time in writing.
SUBSTANCE USE DISORDER RECORDS
(42 CFR Part 2 Protections – If Applicable)
Substance Use Disorder (SUD) records are protected under federal law (42 C.F.R. Part 2) and receive heightened confidentiality protections.
These records may only be disclosed with your explicit written consent except in limited circumstances such as:
Medical emergencies
Reporting crimes on program premises
Child abuse reporting
SUD records cannot be used against you in civil, criminal, administrative, or legislative proceedings without your written consent or a court order consistent with Part 2 regulations.
You may revoke consent at any time in writing.
OUR RESPONSIBILITIES
Maintain the privacy and security of your PHI
Abide by the terms of this Notice
Follow more stringent state or federal laws when applicable
Notify you if a breach compromises your PHI
Provide updated Notices if changes are made
A revised Notice may be obtained by:
Requesting a copy from the Practice
Visiting: www.resilientmindspsychologicalservices.com
Effective Date: September 1, 2025