About Fully Present

Where clarity becomes direction and presence leads to healing.

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Privacy Practices and Client Rights Notice

This notice explains your rights as a client of Fully Present Counseling & Consultation Services, LLC and how your health information may be used and shared. We are committed to protecting your privacy and ensuring you understand both your rights and our responsibilities.


Privacy Practices under HIPAA

We are required by law to keep your health information private and secure. We may use or share your information without your written permission for purposes of treatment, payment, and healthcare operations (TPO):

– Treatment: Coordinating or managing your care with other providers.

– Payment: Submitting claims to your insurance company or processing payments.

– Healthcare Operations: Managing our practice, evaluating quality of care, and other business functions.

We may share your information with business partners, such as billing services or scheduling platforms (e.g., Headway), to help us provide these services. These partners have signed agreements with us promising to protect your privacy.

Other Permitted Disclosures Without Your Written Permission

In certain situations, we may share your information without your written authorization when required or allowed by law, including:

– In a medical or mental health emergency to protect you or others from serious harm.

– When we are mandated to report suspected abuse or neglect of a child, elder, or vulnerable adult.

– When required by a court order or legal process.

– When necessary to comply with public health reporting requirements.

These disclosures are limited to the information necessary to address the specific situation and are made only when legally required or permitted.

Additional HIPAA Rights

– Receive a copy of this notice at any time.

– Request restrictions on certain uses or disclosures of your information (we will inform you if we can comply).

– Request confidential communications (e.g., to be contacted at a different phone number or address).

– Inspect and request a copy of your records (fees may apply).

– Request an amendment to your record if you believe it is incorrect.

– Receive a list of certain disclosures of your health information.

– File a complaint with us or with the U.S. Department of Health and Human Services if you believe your privacy rights have been violated.

Questions or Concerns

If you have any questions about this notice, your rights, or our privacy practices, please contact:
Fully Present Counseling & Consultation Services, LLC
Phone: 419-581-9821
Email: aeryn@fullypresentcounseling.com

As a client, you have the right to:

1. The right to be treated with consideration and respect for personal dignity, autonomy, and privacy.

2. The right to receive services in the least restrictive, most appropriate setting.

3. The right to be free from abuse, neglect, exploitation, and inhumane treatment.

4. The right to participate in any appropriate and available service that is consistent with the service plan, and to refuse any service, treatment, or medication, absent an emergency.

5. The right to be informed of and participate in the formulation of any plan of service.

6. The right to receive a copy of the current service plan and to review it upon request.

7. The right to be free from unnecessary or excessive medication, restraint, or seclusion.

8. The right to be informed and refuse any unusual or hazardous treatment procedures.

9. The right to be advised and refuse observation by techniques such as one-way mirrors, audio and visual recording, or direct observation.

10. The right to confidentiality of communications and personal identifying information within the limitations and requirements of state and federal law.

11. The right to have access to one’s own client record, unless access is restricted for treatment reasons, with a documented plan for removal of restriction.

12. The right to be informed in advance of the reason(s) for termination of services, and to be involved in service termination planning, including referrals.

13. The right to be informed of the reason(s) for denial of a service.

14. The right not to be discriminated against in the provision of services based on race, ethnicity, age, color, religion, gender identity, sexual orientation, national origin, disability, genetic information, HIV status, or other legally protected status.

15. The right to know the cost of services and any limitations on those services.

16. The right to be verbally informed of all rights, and to receive a written copy upon request.

17. The right to exercise rights without reprisal, except when safety is at risk.

18. The right to file a grievance in accordance with the agency’s grievance procedure, and to be provided assistance if needed.

19. The right to be informed of one’s own condition.

20. The right to consult with an independent specialist or legal counsel at one’s own expense.