DESERT SKY FAMILY THERAPY, LLC NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL AND MENTAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. Effective Date: February 2026 I. OUR PLEDGE REGARDING YOUR HEALTH INFORMATION Desert Sky Family Therapy, LLC is committed to protecting the privacy of your Protected Health Information (PHI). PHI is information about you, including demographic information, that may identify you and relates to your past, present, or future physical or mental health condition and related healthcare services. We are required by law to maintain the privacy of your PHI, provide you with this notice of our legal duties and privacy practices, and abide by the terms of this notice currently in effect. II. HOW WE MAY USE AND DISCLOSE YOUR PHI We may use and disclose your PHI for the following purposes without your separate authorization:
For Treatment: We may use your PHI to provide, coordinate, or manage your healthcare and any related services. For example, your provider may consult with another healthcare provider, such as your Primary Care Physician (PCP), to coordinate your care, provided you have not opted out of such coordination.
For Payment: We may use and disclose your PHI so that the treatment and services you receive may be billed and payment may be collected from you, an insurance company (such as Aetna), an EAP program, or a third party.
For Health Care Operations: We may use or disclose your PHI for our practice’s operations, which include internal administration, quality assurance, and training of LMFT Associates.
As Required by Law: We will disclose PHI when required to do so by international, federal, state, or local law.
To Avert a Serious Threat to Health or Safety: Under Texas law and our ethical guidelines, we may use and disclose PHI to medical or law enforcement personnel when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
Abuse or Neglect: We must disclose PHI to the appropriate authorities if we reasonably believe you are a victim of abuse, neglect, or domestic violence, or if you disclose information regarding the abuse of a minor, elderly, or disabled person.
Health Oversight Activities & Judicial Proceedings: We may disclose PHI to a health oversight agency (such as the Texas Behavioral Health Executive Council) for activities authorized by law. We may also disclose PHI in response to a court order or, in certain circumstances, a subpoena.
III. USES AND DISCLOSURES REQUIRING YOUR AUTHORIZATION Other uses and disclosures of your PHI not covered by this Notice or the laws that apply to us will be made only with your written authorization.
Psychotherapy Notes: Notes recorded by your provider documenting the contents of a counseling session and kept separate from the rest of your medical record are given special protection. Most uses and disclosures of psychotherapy notes require your specific written authorization.
Revocation: If you provide us with authorization to use or disclose your PHI, you may revoke that authorization, in writing, at any time.
IV. YOUR RIGHTS REGARDING YOUR PHI You have the following rights regarding the PHI we maintain about you:
Right to Inspect and Copy: You have the right to inspect and obtain a copy of your clinical record. Under Texas law, we must provide this to you within 15 days of receiving your written request. We may charge a reasonable, cost-based fee for copying and mailing.
Right to Amend: If you feel that the PHI we have is incorrect or incomplete, you may ask us to amend the information. We may deny your request if the information was not created by us or is determined to be accurate and complete.
Right to an Accounting of Disclosures: You have the right to request a list of certain disclosures we made of your PHI for purposes other than treatment, payment, or healthcare operations.
Right to Request Restrictions: You have the right to request a restriction or limitation on the PHI we use or disclose for treatment, payment, or operations. We are not required to agree to your request, unless you are paying out-of-pocket in full for a service and request that we do not disclose the information to your health plan.
Right to Request Confidential Communications: You have the right to request that we communicate with you about health matters in a certain way or at a certain location (e.g., only calling your cell phone).
Right to a Paper Copy of This Notice: You have the right to a paper copy of this Notice at any time, even if you have agreed to receive it electronically.
Right to Receive Notice of a Breach: You have the right to be notified upon a breach of any of your unsecured PHI.
V. CHANGES TO THIS NOTICE We reserve the right to change this notice and make the new notice apply to PHI we already have as well as any information we receive in the future. The current notice will be posted in our office and on our website. VI. COMPLAINTS If you believe your privacy rights have been violated, you may file a complaint with our office or with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. You will not be penalized for filing a complaint. To file a complaint with our office, contact: Director: Anna Brown Address: 5504 Wayne Ave, Ste 109, Lubbock, TX 79414 Phone: 806-853-7292 To file a complaint with the federal government: U.S. Department of Health and Human Services Office for Civil Rights 200 Independence Avenue, S.W. Washington, D.C. 20201 Toll-Free Call: 1-877-696-6775
