NOTICE OF PRIVACY PRACTICES (NPP)

Effective Date: 9/1/25
Provider: Emilie Kadlec, MA, LPC
Practice Location: Ohio (providing virtual counseling and coaching)

YOUR RIGHTS

You have the right to:

1. Get an electronic or paper copy of your medical record.
You may ask to see or get a copy of your therapy record. I will provide it within 30 days and may charge a reasonable fee for copying and mailing.

2. Request corrections.
If you think your records are incorrect or incomplete, you can request a correction. I may deny your request but will inform you in writing.

3. Request confidential communications.
You may ask me to contact you in a specific way (for example: phone only, email only, no voicemail). I will accommodate reasonable requests.

4. Ask for limits on what I share.
You can request restrictions on how your information is used or disclosed. I may not be able to agree, but I will always consider your request.

5. Get a list of disclosures.
You may ask for a list of when your information was shared for six years prior to your request.

6. Get a copy of this Notice.
You may request an additional copy at any time.

7. Choose someone to act for you.
If somebody has medical power of attorney or is your legal guardian, that person can exercise your rights.

8. File a complaint if you believe your rights were violated.
You can file a complaint with me or with the U.S. Department of Health and Human Services (HHS).
You will never be penalized for filing a complaint.

YOUR CHOICES

You may tell me your preferences about how your information is used in the following situations:

  • Sharing information with a spouse, partner, or family member

  • Sharing information in a crisis when you cannot express your wishes

  • Using your information for treatment coordination

You can change your preferences at any time.

I will never share your information for marketing, advertising, or sales.

USES AND DISCLOSURES

I typically use or share your health information only in the following ways:

1. Treatment

I use your information to provide clinical care, coordinate with other providers you authorize, and maintain accurate treatment records.

2. Payment

If applicable, your information may be used to process payments, insurance claims, or billing.
(If you operate private pay only, you may say: “I do not bill insurance. Your information is not shared with third-party payers.”)

3. Healthcare Operations

I may use your information for administrative tasks, consultation, quality review, and record keeping.

OTHER PERMITTED USES

I may share your information without your written permission only in these legally required situations:

1. Serious threat to health or safety

If you pose a clear danger to yourself or others, I may share information to prevent harm.

2. Mandated reporting

Ohio law requires therapists to report suspected abuse or neglect of children, elders, or dependent adults.

3. Court orders and legal processes

I may disclose information if ordered by a court or subpoena, within legal limits.

4. Public health and government requests

Such as investigations or mandated reporting requirements.

5. Compliance with HIPAA

For audits, oversight, or investigations by appropriate agencies.

I will only disclose the minimum necessary information required.

YOUR INFORMATION & ELECTRONIC COMMUNICATION

Email, text messaging, or website contact forms may not be fully secure.
By choosing these methods, you acknowledge this risk and consent to communication in these formats.

All digital records are stored in a secure, HIPAA-compliant system.

COACHING VS THERAPY

I provide both counseling (a regulated healthcare service) and coaching (non-clinical personal development).
Coaching is not covered by HIPAA.
All coaching information is still kept private and secure, but it is not classified as Protected Health Information (PHI).
I will always clarify which service you are receiving.

MY RESPONSIBILITIES

I am required by law to:

  • Maintain the privacy and security of your protected health information

  • Provide you with this Notice of Privacy Practices

  • Follow the terms stated in this Notice

  • Inform you if a breach compromises your information

  • Update you if privacy practices change

CHANGES TO THIS NOTICE

I may update this Notice at any time.
Any changes will apply to all information I maintain and will be posted on my website with a new effective date.

QUESTIONS OR COMPLAINTS

If you have questions, concerns, or wish to file a complaint, contact:

Emilie Kadlec, MA, LPC
Email: emilie.kadlec@gmail.com
Phone: 615-669-6114
Location: Ohio

If you wish to file a complaint with the U.S. Department of Health and Human Services:
Office for Civil Rights
U.S. Department of Health & Human Services
1-877-696-6775
www.hhs.gov/ocr/privacy

You will not be punished or denied services for filing a complaint.


For Emilie Kadlec Counseling & Coaching — Ohio, USA
(General template; review with legal counsel before publishing.)