Privacy Practices
Effective Date: July 1, 2025
YOUR INFORMATION. YOUR RIGHTS. OUR RESPONSIBILITIES.
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.
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.
2. DETAILED NOTICE
A. Uses & Disclosures of PHI
Treatment
We may share PHI with other health care providers to coordinate or manage your care.
Payment
We may use and disclose PHI when we bill and collect payment from health plans or other entities.
Health Care Operations
We may use and disclose PHI for quality improvement, staff training, credentialing, licensing, and business planning.
Public Health & Safety
We may report PHI to public health authorities for disease surveillance, reporting, and control.
Abuse, Neglect & Violence
We may notify authorities if we believe an individual is at risk of harm, abuse, neglect, or domestic violence.
Legal & Law Enforcement
We may disclose PHI in response to court orders, subpoenas, or as required by law, and in certain law enforcement situations.
Research
We may share PHI for research purposes when an institutional review board has approved the research protocol.
Coroners, Funeral Directors & Organ Donation
We may disclose PHI as necessary to coroners, funeral directors, or organ procurement organizations.
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
Inspect & Copy
You may request access to your PHI in paper or electronic form. We will respond within 30 days of your request.
Amend
You may request corrections to your PHI. We will respond within 60 days and, if we deny your request, explain why.
Accounting of Disclosures
You may request a list of disclosures of your PHI made for purposes other than treatment, payment, and operations, for up to the past six years.
Request Restrictions
You may request limits on how we use or share your PHI. We are not required to agree, except we will honor requests to restrict disclosures to a health plan when you have paid out of pocket.
Confidential Communications
You may request we communicate with you in a specific way or at a different location.
Receive Notice of Breach
You will be notified if there is a breach of your unsecured PHI.
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.
D. Filing a Complaint
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:
You may file with the U.S. Department of Health & Human Services, Office for Civil Rights:
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: July 1, 2025