Notice of Privacy Practices

Collective Counseling & Consultation LLC

Effective Date: May 27, 2026

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

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I. OUR RESPONSIBILITIES

At  Collective Counseling & Consultation LLC, we understand that health information about you and your care is personal and sensitive. We are committed to protecting the privacy and security of your Protected Health Information (“PHI”).

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We create and maintain records of the care and services you receive from our practice. These records are necessary to provide quality care, comply with legal requirements, and support treatment, payment, and health care operations.

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We are required by law to:

• Maintain the privacy and security of your PHI.

• Provide you with this Notice of Privacy Practices.

• Follow the duties and privacy practices described in this Notice.

• Notify you following a breach of unsecured PHI as required by law.

• Provide adequate notice regarding records protected under 42 C.F.R. Part 2 when applicable.

• Comply with applicable federal and Wisconsin confidentiality laws.

We reserve the right to revise this Notice at any time. Any revised Notice will apply to all PHI maintained by our practice and will be made available upon request, in our office, through the client portal, and on our website.

II. HOW WE MAY USE AND DISCLOSE YOUR INFORMATION

We may use and disclose your PHI for the purposes described below without obtaining your written authorization unless otherwise required by law.

A. Treatment

We may use and disclose your PHI to provide, coordinate, or manage your mental health treatment and related services.

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Examples include:

• Consultation with other treating providers

• Care coordination

• Referrals to specialists or community resources

• Reviewing treatment plans

• Clinical supervision and consultation

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Disclosures for treatment purposes are not limited to the “minimum necessary” standard because providers may require access to complete information in order to provide quality care.

B. Payment

We may use and disclose your PHI to obtain payment for services provided.

Examples include:

• Submitting claims to insurance companies

• Verifying benefits and eligibility

• Reviewing medical necessity

• Collecting outstanding balances

C. Health Care Operations

We may use and disclose your PHI for operational purposes necessary to run our practice.

Examples include:

• Quality improvement activities

• Staff training and supervision

• Compliance reviews

• Business management and administrative activities

• Licensing and accreditation activities

If your records are protected under 42 C.F.R. Part 2, certain uses and disclosures otherwise permitted under HIPAA for treatment, payment, and health care operations may be more limited by federal law.

III. USES AND DISCLOSURES REQUIRED OR PERMITTED BY LAW

We may disclose PHI when required or permitted by federal or Wisconsin law.

A. Abuse, Neglect, or Threats to Safety

We may disclose PHI when required to:

• Report suspected child abuse or neglect

• Report abuse or neglect of vulnerable adults

• Prevent or lessen a serious and imminent threat to health or safety

• Comply with duty-to-warn obligations

Mandatory reporting obligations may arise under Wis. Stat. § 48.981 and other applicable laws.

B. Health Oversight Activities

We may disclose PHI to licensing boards, government agencies, or oversight entities authorized by law.

C. Judicial and Administrative Proceedings

We may disclose PHI in response to a valid court order or other lawful process when required or permitted by law.

 

Wisconsin law provides heightened protections for mental health treatment records under Wis. Stat. §§ 51.30 and 146.82. In many situations, a subpoena alone is insufficient to authorize disclosure.

 

For records protected under 42 C.F.R. Part 2, records or testimony relating to the content of those records generally may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless:

• you provide specific written consent,

• or a court order is issued in accordance with federal law.

D. Law Enforcement Purposes

We may disclose limited PHI to law enforcement when legally required or authorized.

E. Workers’ Compensation

We may disclose PHI as authorized by workers’ compensation laws.

IV. SPECIAL PROTECTIONS FOR MENTAL HEALTH AND SUBSTANCE USE DISORDER RECORDS

A. Mental Health Records

Wisconsin law provides additional protections for mental health treatment records under Wis. Stat. §§ 51.30 and 146.82.

 

Except as permitted or required by law, we will not disclose mental health treatment records without proper authorization.

B. Psychotherapy Notes

Psychotherapy notes are maintained separately from the rest of the medical record when applicable.

 

Psychotherapy notes receive additional protections under HIPAA and generally require written authorization for use or disclosure except in limited circumstances permitted by law, including:

• treatment,

• supervision and training,

• legal defense,

• health oversight activities,

• coroner or medical examiner duties,

• and prevention of serious threats to health or safety.

C. Substance Use Disorder Records (42 C.F.R. Part 2)

Some records relating to substance use disorder diagnosis, treatment, or referral may be protected under federal law (42 C.F.R. Part 2).

 

When applicable:

• We will not use or disclose these records without your written consent unless specifically permitted by law.

• Federal law generally prohibits redisclosure of substance use disorder records unless expressly permitted by written consent or otherwise authorized by law.

• Records protected under 42 C.F.R. Part 2 may not be used in legal proceedings against you without your consent or a qualifying court order.

We may also maintain Substance Use Disorder (SUD) counseling notes documenting the contents of counseling sessions. Any use or disclosure of SUD counseling notes requires separate written authorization and may not be combined with authorization for other records.

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You may revoke consent for disclosure of SUD records or SUD counseling notes at any time except to the extent action has already been taken in reliance upon your authorization.

D. HIV Test Results and Sensitive Health Information

Wisconsin law provides additional protections for HIV test results and certain sensitive health information under Wis. Stat. § 252.15.

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Except as permitted by law, written authorization is generally required prior to disclosure.

V. REPRODUCTIVE HEALTH CARE PRIVACY PROTECTIONS

Federal law prohibits the use or disclosure of PHI for certain investigations or proceedings involving lawful reproductive health care.

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We will not disclose PHI for prohibited purposes related to reproductive health care unless specifically authorized or required by law.

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VI. CERTAIN USES AND DISCLOSURES REQUIRE YOUR WRITTEN AUTHORIZATION

We will obtain your written authorization before:

• Using or disclosing psychotherapy notes except as permitted by law

• Using PHI for marketing purposes requiring authorization

• Selling PHI

• Disclosing information in situations not otherwise described in this Notice

You may revoke your authorization at any time in writing except to the extent we have already relied upon it.

VII. CERTAIN USES AND DISCLOSURES REQUIRE AN OPPORTUNITY TO OBJECT

A. Disclosures to Family, Friends, or Others Involved in Your Care

We may disclose relevant PHI to a family member, friend, or other person involved in your care or payment for your care unless you object.

In emergency situations, consent may be obtained retroactively when permitted by law.

B. Fundraising

If we ever intend to use or disclose records protected under 42 C.F.R. Part 2 for fundraising purposes, you will be provided with a clear opportunity to opt out prior to any such use or disclosure.

VIII. YOUR RIGHTS REGARDING YOUR PHI

You have the following rights regarding your PHI:

1. Right to Request Restrictions

   • You may request restrictions on certain uses or disclosures of your PHI.We are not required to agree to all requested restrictions if doing so would affect your care.

2. Right to Restrict Disclosure to Health Plans

   • If you pay for a service in full out-of-pocket, you may request that we not disclose information regarding that service to your health plan for payment or health care operations purposes.

3. Right to Request Confidential Communications

   • You may request that we contact you in a specific way or at a specific location.

   • We will accommodate reasonable requests.

4. Right to Access and Obtain Copies of Your Records

   • Except for psychotherapy notes and SUD counseling notes, you may request electronic or paper copies of your records.

   • We will generally respond within 30 days and may charge a reasonable cost-based fee when permitted by law.

5. Right to an Accounting of Disclosures

   • You may request a list of certain disclosures of your PHI made outside treatment, payment, and health care operations.

   • You also have the right to request an accounting of disclosures specifically related to records protected under 42 C.F.R. Part 2 when applicable.

6. Right to Request Amendments

   • If you believe information in your records is incorrect or incomplete, you may request an amendment.

   • If we deny your request, we will provide a written explanation within 60 days.

7. Right to a Paper or Electronic Copy of This Notice

   • You may request a paper or electronic copy of this Notice at any time.

8. Right to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with our practice or with the U.S. Department of Health and Human Services.

 

You will not be retaliated against for filing a complaint.

Practice Contact Information

Collective Counseling & Consultation LLC
15400 W Capitol Dr, Ste 105
Brookfield, WI 53005
Phone: 414-367-9155

 

You may also file a complaint with:

U.S. Department of Health & Human Services Office for Civil Rights

IX. MINORS AND CONFIDENTIALITY

Under Wisconsin law, certain minors may consent to outpatient mental health treatment without parental consent in specific circumstances.

 

Wisconsin law may allow minors age 14 and older to consent to certain mental health treatment services without parental involvement.

 

Where permitted by law:

• minors may have confidentiality rights regarding their treatment records,

• and parents or guardians may not automatically have access to those records.

 

We will follow applicable Wisconsin and federal law regarding minors’ confidentiality and parental access.

X. ELECTRONIC COMMUNICATIONS AND TELEHEALTH

Our practice may communicate with you electronically through secure systems, including:

• client portal messaging,

• telehealth platforms,

• email,

• text messaging,

• electronic scheduling systems,

• and billing systems.

We utilize electronic health record systems and HIPAA-compliant technology platforms to support treatment, scheduling, billing, and communication.

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While we take reasonable measures to protect electronic communications, no electronic transmission or storage system can be guaranteed completely secure.

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Clients are encouraged to discuss communication preferences and risks with their provider.

XI. CHANGES TO THIS NOTICE

We reserve the right to change this Notice at any time.

 

Any changes will apply to:

• PHI we already maintain,

• and PHI created or received in the future.

 

Updated versions of this Notice will be made available:

• in our office,

• through the client portal,

• and on our website.

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