Privacy Policy

I. Our Commitment to Confidentiality

As a core principle, Empower to Change will not disclose any information about you, including the fact that you are our client, without your explicit written consent. Your formal Clinical Record, maintained by Empower to Change, documents the psychological services provided to you. This record typically includes dates of sessions, your diagnosis, functional status, reported symptoms, prognosis, progress notes, and any psychological testing reports.

While health care providers are legally permitted to use or disclose records or information for treatment, payment, and health care operations, Empower to Change does not routinely disclose information under these circumstances without your prior permission. Therefore, we will require your permission in advance, either through your general consent provided at the onset of our professional relationship (by signing the accompanying consent form), or through your specific written authorization each time a need for disclosure arises. You retain the right to revoke your permission, in writing, at any time, by contacting Empower to Change.

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II. Limits of Confidentiality: Permitted & Required Disclosures Without Consent

There are specific, legally mandated exceptions to our rule of strict confidentiality. By choosing to receive psychological services from Empower to Change, you agree to these limits of confidentiality. We will discuss these important exceptions with you, and you are welcome to reopen this conversation at any point during our work together.

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Empower to Change may use or disclose your Clinical Record or other information about you without your consent or authorization in the following legally required or permitted circumstances:

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• Emergencies: If you are experiencing a life-threatening emergency and we are unable to obtain your direct permission, we may share necessary information if we believe it aligns with your best interests or would be helpful to you.

• Child Abuse or Neglect: As mandated by Florida law, if we have reason to suspect that a child is being abused, neglected, or abandoned, we are legally required to report this matter immediately to the Florida Department of Children and Families (DCF).

• Adult Abuse, Neglect, or Exploitation: In accordance with Florida law, if we have reason to suspect that an elderly person or an incapacitated adult is being abused, neglected, or exploited, we are legally required to immediately make a report and provide relevant information to the Florida Department of Children and Families (DCF) or other appropriate protective services.

• Health Oversight: Florida law requires licensed psychologists and counselors to report misconduct by a health care provider within their own profession. As a policy, Empower to Change also reserves the right to report misconduct by health care providers of other professions. If you describe unprofessional conduct by another mental health provider, regardless of their profession, we are legally required to inform you how to make such a report. Furthermore, if you are a health care provider yourself, we are legally required to report to your respective licensing board that you are receiving treatment from us if we believe your condition poses a risk to the public. Florida Licensing Boards possess the authority to subpoena relevant records when investigating complaints of provider incompetence or misconduct.

• Judicial or Administrative Proceedings: If you are involved in a court proceeding, and a request is made for information about your diagnosis, treatment, and related records, such information is typically privileged under Florida state law. We will not release such information unless we receive your written authorization, or a valid subpoena or court order has been issued. In cases of a subpoena or court order, we will make reasonable efforts to notify you, and we will not release information if you or your legal representative properly notify us that you are opposed to the disclosure. Please be aware that protections of privilege may not apply if our services involve an evaluation conducted for a third party (e.g., for employment or legal purposes) or where the evaluation is directly court-ordered. You will be informed in advance if such circumstances apply.

• Serious Threat to Health or Safety: Under Florida law, if you communicate to us a specific and immediate threat to cause serious bodily injury or death to an identified or identifiable person, and we believe you have the intent and ability to carry out that threat immediately or imminently while engaged in our professional duties, we are legally required to take steps to protect third parties. These precautions may include: (1) warning the potential victim(s), or the parent or guardian of the potential victim(s) if under 18; (2) notifying a law enforcement officer; or (3) seeking your hospitalization. Empower to Change, by its own policy, also reserves the right to use and disclose your medical information when necessary to prevent an immediate, serious threat to your own health and safety.

• Workers' Compensation: If you file a worker's compensation claim, we are legally required, upon request, to submit your relevant mental health information to you, your employer, the insurer, or a certified rehabilitation provider.

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Any other uses and disclosures of information not specifically covered by this policy or by applicable laws will only be made with your explicit written permission.

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III. Your Rights Regarding Protected Health Information (PHI)

You have specific rights concerning your Protected Health Information (PHI) maintained by Empower to Change:

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• Right to Request Restrictions: You have the right to request restrictions on certain uses and disclosures of your PHI. This includes requesting limits on the medical information we disclose to someone involved in your care or the payment for your care. While we will consider your request, Empower to Change is not obligated to agree to all requested restrictions. To request restrictions, you must submit your request in writing to our office, specifying: (1) what information you wish to limit; (2) whether you wish to limit our use, disclosure, or both; and (3) to whom you want the limits to apply.

• Right to Receive Confidential Communications by Alternative Means and at Alternative Locations: You have the right to request and receive confidential communications of PHI by alternative means or at alternative locations (e.g., if you prefer not to receive mail or phone calls at your home address). Upon your written request, we will accommodate reasonable requests for alternative communication methods. To request alternative communication, you must submit your request in writing, clearly specifying how or where you wish to be contacted.

• Right to an Accounting of Disclosures: You generally have the right to receive an accounting of disclosures of PHI for which you have neither provided consent nor authorization (as described in Section II of this policy). Upon your written request, we will discuss the details of this accounting process with you.

• Right to Inspect and Copy: In most cases, you have the right to inspect and obtain a copy of your medical and billing records. To exercise this right, you must submit your request in writing to Empower to Change. If you request a copy of the information, a reasonable fee may be charged to cover the costs of copying and mailing. We may deny your request to inspect or copy in certain circumstances, particularly for psychotherapy notes or information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative proceeding.

• Right to Amend: If you believe that the Protected Health Information we maintain about you is incorrect or incomplete, you may request that we amend the information. To request an amendment, your request must be made in writing and submitted to Empower to Change, along with a reason that supports your request. We may deny your request if you ask us to amend information that: (1) was not created by Empower to Change (though we will add your request to the record); (2) is not part of the medical information maintained by us; (3) is not part of the information which you would be permitted to inspect and copy; or (4) is not accurate and complete.

• Right to a Paper Copy of This Policy: You have the right to obtain a paper copy of this policy at any time. You may ask us to provide you with a copy.

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IV. Empower to Change's Duties

As a healthcare provider, Empower to Change has specific legal duties concerning your PHI:

• We are legally required to maintain the privacy of your Protected Health Information and to provide you with this policy outlining our legal duties and privacy practices concerning PHI.

• We reserve the right to change our privacy policies and practices as described in this policy. However, unless you are otherwise notified of such changes, we are required to abide by the terms currently in effect.

• Any changes we may make to our privacy policy in the future will be posted on this page and, where appropriate, notified to you by e-mail.

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V. Complaints

If you believe your privacy rights have been violated, you may file a complaint. To file a complaint directly with Empower to Change, you must submit your request in writing to our office. You may also send a written complaint to the U.S. Department of Health and Human Services.