1. OUR COMMITMENT TO YOUR PRIVACY

Lake Austin Psychotherapy “we”; “our,” or “the Practice” is committed to protecting the privacy and security of your personal information and Protected Health Information (PHI) in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the HITECH Act, and applicable Texas state laws, including the Texas Medical Records Privacy Act. This Notice of Privacy Practices describes how we collect, use, disclose, and safeguard your health information.

2. PROTECTED HEALTH INFORMATION (PHI)

Protected Health Information includes any individually identifiable information related to your past, present, or future physical or mental health condition, the provision of healthcare to you, or payment for such healthcare. This includes, but is not limited to:

- Your name, address, date of birth, phone number, and email address
- Medical and psychiatric history
- Clinical notes, treatment plans, and progress notes
- Diagnosis and assessment information
- Information related to EMDR therapy, ketamine-assisted psychotherapy, or other treatments provided
- Insurance and billing information
- Information collected through our telehealth platform
- Information submitted through our website contact form

3. HOW WE COLLECT YOUR INFORMATION

We collect information in the following ways:

a) Directly from you: When you complete intake forms, provide medical history, participate in therapy sessions (in-person or via telehealth), submit information through our website contact form, or communicate with us by phone, email, or text message.
b) From your other healthcare providers: With your written authorization, we may receive records from physicians, therapists, or other providers involved in your care.
c) From our website: When you visit lakeaustinpsychotherapy.com, we may collect standard web analytics data such as IP addresses, browser type, pages visited, and time spent on site. This website analytics data is not PHI and is collected through cookies and similar technologies for the purpose of improving site functionality and user experience.

4. HOW WE USE AND DISCLOSE YOUR PHI

We may use and disclose your PHI without your authorization for the following purposes:

a) Treatment: To provide, coordinate, and manage your mental healthcare and related services. This includes sharing information among members of your treatment team at Lake Austin Psychotherapy (e.g., your therapist, our medical director, and supervising clinicians) as necessary for your care. For ketamine-assisted psychotherapy, relevant medical information will be shared between your therapist and our supervising physician , Dr. Truman Milling, MD, to ensure safe and coordinated treatment.
b) Payment: To obtain payment for services provided to you, including billing, claims management, and collection activities. If you choose to seek reimbursement from your insurance provider, we may disclose necessary information to facilitate that process.
c) Healthcare Operations: To support business activities of the Practice, including quality assessment, staff training, licensing, and accreditation activities.
d) As Required or permitted by Law: We may disclose PHI when required to do so by federal, state, or local law, including:
- Reporting suspected abuse, neglect, or domestic violence
- Responding to a court order or subpoena
- Reporting to public health authorities for the purpose of preventing or controlling disease
- Reporting to the Food and Drug Administration (FDA) regarding adverse events
- Complying with workers’ compensation laws
- Responding to law enforcement requests under specific legal circumstances
e) To Avert a Serious Threat: We may use and disclose PHI when necessary to prevent a serious and imminent threat to your health or safety or the health or safety of others.
f) Psychotherapy Notes: We maintain psychotherapy notes (also known as process notes) separately from your medical record. Psychotherapy notes receive additional protections under HIPAA, and we will not disclose them without your written authorization except in limited circumstances permitted by law, such as to defend against a legal action brought by you, or when required for oversight of your therapist’s practice.

5. USES AND DISCLOSURES REQUIRING YOUR WRITTEN AUTHORIZATION

We will obtain your written authorization before using or disclosing your PHI for purposes not described in this Notice, including but not limited to:
- Marketing purposes
- Sale of your PHI
- Most uses of psychotherapy notes
- Disclosures to third parties not involved in your treatment or payment
You may revoke your authorization at any time in writing, except to the extent that we have valready acted in reliance upon it.

6. TELEHEALTH PRIVACY

Lake Austin Psychotherapy offers encrypted telehealth therapy sessions throughout Texas. Our telehealth services are provided through a HIPAA-compliant video platform that uses end-to-end encryption to protect the confidentiality of your sessions. Please be aware that:
- We recommend conducting telehealth sessions from a private location where you cannot be overheard.
- We cannot guarantee the security of information transmitted over the internet or via electronic devices outside of our control.
- Standard email and text messaging (SMS) are not considered secure methods of communication. By choosing to communicate with us via email or text, you acknowledge and accept the associated risks to confidentiality.
- We use commercially reasonable safeguards to protect electronic communications, but no system can be guaranteed to be completely secure.

7. WEBSITE CONTACT FORM

Information submitted through the contact form on our website is transmitted using standard web encryption (SSL/TLS). However, please be aware that submitting sensitive health information through a website contact form carries inherent risks. We encourage you to limit the personal health information you include in contact form submissions and to share detailed health information only during a secure telehealth session or in-person visit.

8. YOUR RIGHTS REGARDING YOUR PHI

Under HIPAA and Texas law, you have the following rights:
a) Right to Access: You have the right to inspect and obtain a copy of your PHI maintained in our records. Requests must be submitted in writing. We may charge a reasonable, cost-based fee for copies as permitted by Texas law.
b) Right to Amend: You have the right to request an amendment to your PHI if you believe it is incorrect or incomplete. Requests must be submitted in writing with a reason for the amendment. We may deny your request under certain circumstances as permitted by law, and we will provide you with a written explanation of any denial.
c) Right to an Accounting of Disclosures: You have the right to request a list of certaindisclosures we have made of your PHI. This accounting does not include disclosures made for treatment, payment, or healthcare operations, or disclosures you authorized in writing.
d) Right to Request Restrictions: You have the right to request restrictions on certain uses and disclosures of your PHI. We are not required to agree to your request except in the case where the disclosure is to a health plan for payment or healthcare operations and the PHI relates to a service for which you have paid out of pocket in full.
e) Right to Request Confidential Communications: You have the right to request that we communicate with you about healthcare matters in a certain way or at a certain location. For example, you may request that we contact you only by mail or at a specific phone number.
f) Right to a Copy of This Notice: You have the right to obtain a paper copy of this Notice at any time by contacting our office.
g) Right to Be Notified of a Breach: You have the right to be notified in the event of a breach of your unsecured PHI, as required by the HITECH Act.

9. OUR DUTIES

Lake Austin Psychotherapy is required to:
- Maintain the privacy of your PHI as required by law
- Provide you with this Notice of our legal duties and privacy practices
- Follow the terms of the Notice currently in effect
- Notify you if we are unable to agree to a requested restriction on how your information is used or disclosed
- Notify you in the event of a breach of unsecured PHI

10. DATA SECURITY

We implement administrative, physical, and technical safeguards to protect your PHI, including:
- Secure, encrypted electronic health record systems
- Password-protected access to all systems containing PHI
- HIPAA-compliant telehealth platform with end-to-end encryption
- Staff training on HIPAA privacy and security requirements
- Physical safeguards at our office location including secured records storage
- Business Associate Agreements with all third-party vendors who may access PHI on our behalf

11. MINORS

The privacy of minors (individuals under 18 years of age) is protected under both HIPAA and Texas state law. Parents or legal guardians generally have the right to access a minor’s PHI, subject to certain exceptions under Texas law. We will comply with applicable state and federal laws regarding the treatment and privacy rights of minors.

12. COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with:
a) Lake Austin Psychotherapy
1504 Wood Acre Ln, Austin, TX 78733
Phone: 512-666-1184
Email: info@lakeaustinpsychotherapy.com
b) The U.S. Department of Health and Human Services Office for Civil Rights
Website: www.hhs.gov/ocr/privacy/hipaa/complaints
Phone: 1-877-696-6775
c) The Texas Attorney General
Website: www.texasattorneygeneral.gov
Phone: 1-800-252-8011
You will not be retaliated against for filing a complaint.

13. CHANGES TO THIS NOTICE

We reserve the right to change the terms of this Notice and to make the new provisions effective for all PHI we maintain. If we make material changes to this Notice, we will post the revised Notice on our website at www.lakeaustinpsychotherapy.com and make it available at our office. The effective date of the most current Notice will be listed at the top of this page.

14. WEBSITE ANALYTICS AND COOKIES

Our website uses analytics tools and cookies to understand how visitors interact with our site. This data may include pages visited, time on site, referring websites, and general geographic location. This information is used to improve website functionality and does not include PHI. You may disable cookies through your browser settings, though this may affect site functionality.

15. CONTACT INFORMATION

If you have questions about this Notice or our privacy practices, please contact:
Privacy Officer
Lake Austin Psychotherapy
1504 Wood Acre Ln
Austin, TX 78733
Phone: 512-666-1184
Email: info@lakeaustinpsychotherapy.com

BY USING OUR SERVICES, YOU ACKNOWLEDGE THAT YOU HAVE RECEIVED AND REVIEWED THIS NOTICE OF PRIVACY PRACTICES.