Notice of Privacy Practices

Grounded Light Counseling is committed to protecting the privacy of your health information. This Notice describes how we may use and disclose your Protected Health Information (PHI), your rights under HIPAA, and our legal duties. We may use and disclose your health information for treatment, payment, and health care operations as described in this notice. Certain records, including substance use disorder treatment records, may be subject to additional federal protections.

Please review it carefully.

Effective Date 2/16/26

Our promise to you

I understand that health information about you and your health care is personal. I am committed to protecting health information about you. I create a record of the care and services you receive from me. I need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this mental health care practice. This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you, and describe certain obligations I have regarding the use and disclosure of your health information.



I am required by law to: 

• Make sure that protected health information (“PHI”) that identifies you is kept private. 

• Give you this notice of my legal duties and privacy practices with respect to health information. 

• Follow the terms of the notice that is currently in effect. 

• We may change the terms of this Notice. Any revised Notice will be posted on our website and provided in the client portal. You may request a printed copy at any time and we will provide one promptly.


1. SUMMARY OF KEY POINTS

How We May Use and Disclose PHI

  • Treatment: We use and share PHI to provide, coordinate, or manage your health care and related services.
  • Payment: We use and share PHI to bill and collect payment for the care you receive.
  • Health Care Operations: We use and share PHI for operations that support our ability to provide quality care (e.g., training, audits).

Your Rights

  • Inspect and copy your PHI
  • Request amendment of your PHI
  • Receive an accounting of disclosures of your PHI
  • Request restrictions on certain uses and disclosures
  • Request confidential communications
  • Obtain a paper copy of this notice

How to File a Complaint

If you believe your privacy rights have been violated, you may file a grievance with Grounded Light Counseling (see Section 4) or with the U.S. Department of Health & Human Services, Office for Civil Rights, without fear of retaliation.

Full Notice of Privacy Practices (PDF)

2. DETAILED NOTICE

A. Uses & Disclosures of PHI

1. Treatment

We may share PHI with other health care providers to coordinate or manage your care.

2. Payment

We may use and disclose PHI when we bill and collect payment from health plans or other entities.

3. Health Care Operations

We may use and disclose PHI for quality improvement, staff training, credentialing, licensing, and business planning.

4. Public Health & Safety

We may disclose PHI when required by law for public health activities, reporting abuse or neglect, preventing serious threats to health or safety, or complying with health oversight agencies. Some types of records, including substance use disorder treatment records, may have additional restrictions.

5. Abuse, Neglect & Violence

We may notify authorities if we believe an individual is at risk of harm, abuse, neglect, or domestic violence.

6. Legal & Law Enforcement

Some disclosures may be required or permitted by law (for example; reporting abuse, imminent risk of harm, court orders, or public health reporting). Certain substance use disorder treatment records may require additional legal processes before disclosure, as required by federal law.

7. Research

We may share PHI for research purposes when an institutional review board has approved the research protocol.

8. Coroners, Funeral Directors & Organ Donation

We may disclose PHI as necessary to coroners, funeral directors, or organ procurement organizations.

9. Health Oversight & Threats

We may disclose PHI for audits, investigations, or to prevent a serious threat to health or safety.


Uses & disclosures requiring your authorization

Uses such as marketing communications, sale of PHI, and psychotherapy notes (beyond summary of treatment) require your written authorization.


B. Your Rights & How to Exercise Them

1. Inspect & Copy

You may request access to your PHI in paper or electronic form. We will respond within 30 days of your request.

2. Amend

You may request corrections to your PHI. We will respond within 60 days and, if we deny your request, explain why.

3. Accounting of Disclosures

You may request an accounting of disclosures for the past 6 years (or shorter period permitted by law). You have the right to request a list of certain disclosures we have made of your health information. This includes certain disclosures of substance use disorder information as required by federal law.

4. Request Restrictions

You may request a restriction on certain uses/disclosures (we must honor a request if you paid out-of-pocket in full for a service). You may request restrictions on certain uses or disclosures of your health information. We are not required to agree to all requests. Special protections may apply to substance use disorder treatment records.

5. Confidential Communications

You may request we communicate with you in a specific way or at a different location.

6. Receive Notice of Breach

You will be notified if there is a breach of your unsecured PHI.

7. Paper Copy of Notice

You may obtain a paper copy of this notice at any time, even if you agreed to receive it electronically.


To exercise any of these rights, contact:

Privacy & Compliance Officer
Grounded Light Counseling
2519 South Shields Street, Suite 1K 1063
Fort Collins, CO 80526
Phone: (970) 236-8932
Email: privacy@groundedlightcounseling.com


C. Our Responsibilities

  • We are required by law to maintain the privacy of your PHI and provide you this Notice.
  • We must follow the terms of this Notice as long as it remains in effect.
  • We may change our privacy practices at any time and these changes will apply to PHI we already have.
  • The revised Notice will be posted on our website and available in our office.
  • Full Notice of Privacy Practices (PDF) — The complete Notice of Privacy Practices for Grounded Light Counseling is available for download here: Download Full Notice of Privacy Practices (PDF). This is the official Notice clients will be asked to acknowledge in the intake portal. If you would like a printed copy, contact privacy@groundedlightcounseling.com and we will mail one.


Special Protections for Substance Use Disorder Records

Some health information related to substance use disorder diagnosis, treatment, or referral for treatment may be protected by additional federal confidentiality laws (42 CFR Part 2).

Where applicable, we will obtain your written consent before using or disclosing substance use disorder treatment records for treatment, payment, and health care operations, unless an exception applies.

Once disclosed with your consent for these purposes, federal law may permit the recipient to further use or disclose the information as allowed under HIPAA.

You have the right to revoke your consent for these disclosures at any time, except to the extent that we have already acted in reliance on it.


D. Filing a Complaint

If you believe your privacy rights have been violated, you may file a complaint with our office or with the U.S. Department of Health and Human Services Office for Civil Rights. You will not be penalized for filing a complaint.

Complaints regarding substance use disorder confidentiality may also be subject to federal enforcement laws.
If you believe your privacy rights have been violated:

Internal Grievance:

  • Submit a grievance in writing or verbally to our Privacy & Quality Manager (see contact above, and our Grievance tab).
  • We will acknowledge receipt within 5 business days and respond in writing within 15 calendar days.

External Complaint:

No one may retaliate against you for filing a complaint.

3. WEBSITE PRIVACY POLICY (NON-PHI)

Grounded Light Counseling respects your privacy and protects personal data collected on our website. This policy explains:

  • Data We Collect: Name, email, IP address, cookies, form responses.
  • How We Use It: To schedule sessions, send reminders, improve our site, and comply with legal obligations.
  • Your Rights: Colorado residents may access, correct, delete, or opt-out of the sale of personal data.
  • Contact Us: privacy@groundedlightcounseling.com | (970) 236-8932
  • Last updated: January 31, 2026

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