Notice of Privacy Practices

Effective Date: 10/01/2026

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

C. C. Rogers Counseling, PLLC is required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and applicable state law to protect the confidentiality of your health information. This Notice explains the ways in which your protected health information may be used and disclosed, your rights regarding that information, and the practice's legal duties.

WAYS IN WHICH WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION

We may use and disclose your protected health information for the following purposes:

• Treatment: Providing, coordinating, or managing mental health care and related services. This may include disclosures to other health care providers involved in your care and, when applicable, disclosures associated with training or consultation.
• Payment: Activities such as obtaining payment for mental health services from you, your insurance company, or another third-party payer. For example, information may be included with a bill to a third-party payer that identifies you, your diagnosis, and procedures performed.
• Health care operations: Business and administrative activities necessary to operate the practice, such as quality assessment, compliance, practice administration, and evaluation of services.

We may contact you to provide appointment reminders or other practice-related communications. We may disclose your protected health information to a person you identify as being involved in your care or payment for your care, as permitted by law.

We will use and disclose your protected health information when required by federal, state, or local law. Certain disclosures may also be required or permitted in circumstances involving suspected abuse or neglect, threats to health or safety, judicial or administrative proceedings, law enforcement, or other legally authorized purposes.

Any other uses and disclosures will be made only with your written authorization when authorization is required by law. You may revoke an authorization in writing except to the extent that the practice has already taken action in reliance on it or another legal exception applies.

YOUR HEALTH INFORMATION RIGHTS

Unless otherwise required by law, the practice maintains the records it creates or receives in connection with your care. You have certain rights with respect to your protected health information, including the right to:

• Receive a copy of this Notice of Privacy Practices upon request.
• Request restrictions on certain uses and disclosures of your protected health information for treatment, payment, and health care operations. You may also request that information not be disclosed to a health plan for payment or health care operations when you have paid in full out of pocket for the services, as provided by law. The practice is not required to agree to every requested restriction.
• Request confidential communications of protected health information by reasonable alternative means or at alternative locations when permitted by law.
• Inspect and obtain a copy of protected health information contained in your clinical and billing records, subject to applicable law and any permitted exceptions. Requests should be submitted in writing. Applicable law governs response times, fees, and any permitted denial or review process.
• Request an amendment to your protected health information if you believe it is incorrect or incomplete. The practice may deny a request when permitted by law. Any agreed amendment will be added to, rather than replace, the existing record.
• Receive an accounting of certain disclosures of protected health information, subject to the exceptions provided by law.
• Revoke an authorization to use or disclose health information, except to the extent the practice has already acted in reliance on that authorization or another legal exception applies.
• Receive notification as required by law if you are affected by a breach of unsecured protected health information.

OUR RESPONSIBILITIES

We are required to maintain the privacy of your health information, provide you with this notice of our legal duties and privacy practices, and abide by the terms of the notice currently in effect. We reserve the right to change our privacy practices and make the new provisions effective for all protected health information we maintain, as permitted by law. If our information practices materially change, a revised notice will be made available as required by law, including through this website when applicable.

FOR MORE INFORMATION OR TO REPORT A PROBLEM

If you have questions about this notice or would like additional information, you may contact the privacy officer:

Chuck Rogers, MA, LPC
C. C. Rogers Counseling, PLLC
113 W. Park Dr., Little Elm, TX 75068
(312) 613-4337
chuck@ccrogerscounseling.com

If you believe your privacy rights have been violated, you may file a complaint with the practice or with the Secretary of the U.S. Department of Health and Human Services, Office for Civil Rights. The practice will not retaliate against you for filing a privacy complaint.

For more information about HIPAA or to file a complaint, you may contact the U.S. Department of Health & Human Services, Office for Civil Rights:

U.S. Department of Health & Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
(202) 619-0257
Toll Free: 1-877-696-6775

We reserve the right to change the terms of this notice and make new provisions effective for all protected health information we maintain. You may request a written copy of a revised notice from the practice.