Revised February 2026
THIS NOTICE DESCRIBES HOW MEDICAL/MENTAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. A COPY CAN BE PROVIDED UPON REQUEST.
The law protects the privacy of communications between a client and therapist. In most situations, we can only
elease information about your treatment to others if you sign a written authorization form that meets certain legal requirements imposed by HIPAA (Health Insurance Portability and Accountability Act of 1996). There are othersituations that require only that you provide written advanced consent.
- HIPAA PRIVACY RULE -
Health Insurance Portability and Accountability Act (HIPAA) was signed into federal law in 1996 (Public Law 104-191). HIPAA requires the Secretary of the Department of Health and Human Services to adopt standards for electronic transactions in order to protect individuals’ medical records and other individually identifiable health information (“protected health information” or PHI). The Privacy Rule requires that appropriate safeguards are put into play in order to protect the privacy of PHI and sets limits and conditions on the uses and disclosures that may be made without an individual’s authorization.
As described in above sections, you consent to BZA Behavioral Health using and/or providing PHI in order to (1) provide, manage, and coordinate care within BZA Behavioral Health and with other clinicians with a valid release of information, (2) seek reimbursement for treatment from third-party payors, and (3) administrative purposes like authorizations and treatment reviews.
As described in above sections, BZA Behavioral Health may disclose your PHI without consent in instances of (1) abuse or suspected abuse, (2) serious danger or risk to self or others, or(3) if mandated or ordered by a court of law. Additionally, BZA Behavioral Health may disclose PHI without consent if (4) a government agency is requesting information for health oversight activities or(5) if a client files a complaint or lawsuit against us, we may disclose relevant information regarding the client in order to defend ourselves.
You have the right to make a written request for an accounting of disclosures made of your health information with the following exceptions: disclosure for treatment, payment or healthcare operations; disclosures pursuant to a signed release; disclosures made to the client; disclosures for national security or law enforcement purposes. Note that Healthcare providers cannot release any information regarding a patient or potential patient without proper release or documentation (such as a warrant and/or signed and valid ROI).
You should be aware that the potential for information disclosed pursuant to the HIPAA Privacy Rule to be subject to redisclosure by the recipient and no longer protected by the HIPAA Privacy Rule. BZA is not responsible for the privacy or protection of files that it has been authorized to disclose.
The Privacy Rule also gives individuals rights over their PHI, including rights to examine and obtain a copy of their health records, to direct a covered entity to transmit to a third party an electronic copy of their PHI in an electronic health record, and to request corrections. The laws and standards of our profession require that clinicians maintain treatment records for all clients. BZA Behavioral Health keeps records regarding your reason for seeking treatment, a description of the ways in which your problems impact your life, your diagnosis, your treatment plan, and your progress toward your treatment goals.
With a written authorization, you have the right to release your medical records to others. You also have the right to revoke that release in writing. (Revocation is not valid to the extent that we have already acted in reliance on your previous authorization.)
You have the right to make a written request to inspect and copy your records. You will be charged $0.10/page for copying in addition to any mailing costs. We do our best to promptly deliver such records to you upon payment, but all records will be delivered within 30 days per HIPAA requirement. We may, under some circumstances, deny this request.
You have the right to make a written request that we amend your records. We will have at least 30 days to decide whether to amend your records as you have requested, and in some instances may deny your request. If your request is denied, you have the right to file a disagreement statement. Your disagreement statement and our response will be filed in the record.
- HIPAA SECURITY RULE -
The HIPAA Security Rule establishes national standards to protect individuals’ electronic PHI that is created, received, used, or maintained by a covered entity (like BZA Behavioral Health). The Security Rule requires appropriate administration, physical, and technical safeguards to ensure the confidentiality, integrity, and security of electronic PHI.
As such, BZA Behavioral Health has enacted several policies to secure your PHI on electronic
platforms:
Website:
BZA Behavioral Health’s website is available for general information services only. BZA Behavioral Health does not use its website for clients to communicate clinical or urgent-related concerns or needs. While BZA Behavioral Health does use email to communicate, please do not utilize email for urgent matters. You must contact BZA Behavioral Health by phone for all client clinical or urgent concerns, as the website is for general information only and not meant for communicating clinical issues or emergencies.
Email:
BZA Behavioral Health requires you to limit your use of email as a means of communication with your clinician. If provided and given consent, BZA Behavioral Health may use your email address for appointment reminders, monthly invoices/statements, credit card receipts, and BZA Newsletters. Your clinician may utilize your email address to communicate about scheduling or other nonclinical matters.
All emails received by or sent from BZA may be made a part of the client’s record. BZA Behavioral Health may forward emails internally to the practice staff as necessary for diagnosis, treatment, reimbursement, and other administrative handling. BZA Behavioral Health will not forward emails to independent third parties without the client’s prior written consent.
Social Media:
BZA Behavioral Health employs social media accounts as a means of marketing and psychoeducation with the community. It is your choice as to whether to connect with our business on these sites- we cannot guarantee your confidentiality on these sites. In an effort to maintain the professional nature of our relationships, the providers at BZA Behavioral Health do not accept requests from current or former clients on personal social networking sites.
For questions, concerns, or to make a complaint about a HIPAA violation, please contact us at (847)221-5622 or email us at [email protected] to reach a member of the administrative team. You also have the right to to complain to the US Department of Health and Human Services if you feel that your privacy rights have been violated.