Notice of Privacy Practices
GreenZone Professional Counseling
111 Walker Drive Unit A, Edinboro, PA 16412
Phone: (814) 734-0199 | Email: office@greenzonecounseling.com
Privacy Compliance Officer: Wesley McWilliams
Effective Date: May 1, 2021 (Updated July 2026)
THIS NOTICE DESCRIBES HOW MEDICAL AND MENTAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. Understanding Your Health Record / Information Each time you visit GreenZone Professional Counseling, a record of your visit is made. Typically, this record contains your symptoms, clinical assessments, diagnoses, treatment plan, progress notes, and a plan for future care. In this notice, your health information refers to your standard mental health chart as well as any protected substance use disorder (SUD) patient records maintained by our program. This unified record serves as the basis for planning your care, documenting treatment, billing for services and ensuring full compliance with both general healthcare regulations and strict federal substance use confidentiality laws. Your Health Information Rights When it comes to your health information, you have certain rights. This section explains your rights and our core responsibilities to assist you:
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Consent to Most Uses and Disclosures: You have the right to provide consent before we use or share your health information for most purposes, including standard treatment, payment, and internal operations. You may provide a single, comprehensive consent to cover all future healthcare operations, or request more limited sharing.
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Get an Electronic or Paper Copy of Your Record: You can ask to see or get an electronic or paper copy of your clinical and billing records. We will provide a copy or summary of your information, usually within 30 days of your request, and may charge a reasonable, cost-based fee. Mandatory Legal Exception: This right does not apply to raw, subjective Psychotherapy Notes, which are kept separate under HIPAA to protect the clinical integrity of your therapy.
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Ask Us to Correct Your Record: You can ask us to correct health information about you that you believe is incorrect or incomplete. We may deny your request if the record is accurate and complete, but we will provide you with a detailed written explanation of our decision within 60 days.
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Request Confidential Communications: You can ask us to contact you in a specific way (for example, cell phone, home phone, or portal message) or to send mail to a alternate address. We will agree to all reasonable requests.
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Ask Us to Limit What We Share: You can ask us not to use or share certain health information for treatment, payment, or our operations after you have provided consent. We are not required to agree to your request, and we may say “no” if it could directly affect your clinical care.
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Out-of-Pocket Payment Restrictions: If you pay for a service or care item out-of-pocket in full, you can request that we do not share that information with your health insurer for payment or operational purposes. We will say “yes” to this restriction unless a specific law requires us to share that information.
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Get a List of Shared Electronic Records (Accounting): You can ask for a list (accounting) of the times we’ve shared your electronic health records, including who we shared them with and why. We will include disclosures except those explicitly authorized by you or excluded by standard operation. We also provide a list of health care providers who have received your information through authorized third parties (such as health information networks). We provide one accounting per year for free, but will charge a reasonable, cost-based fee for additional requests within 12 months.
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Choose in Advance About Fundraising: You have the right to a clear and obvious notice in advance of, and a choice about whether to receive, any fundraising communications for our program using your information. (Note: GreenZone Professional Counseling does not engage in fundraising).
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Choose Someone to Act for You: If someone possesses a valid medical power of attorney or serves as your legally appointed guardian, that person can exercise your rights and make choices about your health information. We will verify their legal authority before taking any action.
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File a Complaint If Your Rights Are Violated: You can complain if you feel we have violated your rights by contacting our Privacy Compliance Officer, Wesley McWilliams, directly. You can also file a formal complaint with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.
Your Choices & Disclosures with Express Consent For certain health information, you can tell us your choices about what we share. If you have a clear preference, talk to us and we will follow your instructions. With your formal written consent, we typically use and share your health information in the following ways:
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Treat You: We use and share your information with other healthcare professionals who are actively treating you to coordinate care and avoid medication complications.
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Run Our Organization: We use and share your information to manage our practice operations, improve the quality of your care, and contact you through secure means when necessary.
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Bill for Your Services: We send your information to health insurance plans or other billing entities so they will process payments for your services.
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Authorized Sharing: We share data with any individual, family member, or entity you explicitly name in a signed information release form.
Strict Limitations on Permissible Disclosures WITHOUT Consent Federal law (including 42 CFR Part 2 and HIPAA) strictly limits when we are permitted or required to share your health or substance use disorder records without your explicit consent. We must meet rigorous legal conditions before doing so:
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Internal Communications: We can share information internally within our program and with specific contractors (Business Associates) who directly help us manage our billing, electronic records, and administrative practice operations.
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Bona Fide Medical Emergencies: We can share your identifying information during an acute, life-threatening medical emergency with responding medical personnel and emergency room staff if you are physically unable to provide consent. We can also report to the FDA to notify you or your physician about unsafe products you may be using.
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Suspected Child Abuse and Neglect: We are legally mandated to report suspected child abuse or neglect to the appropriate state authorities, disclosing only the information strictly required by law.
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Crimes or Threats on Our Premises: We may report directly to law enforcement if a patient commits, or threatens to commit, a crime within our practice location or against our staff members.
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Audits, Evaluations, and Research: We can use or share information for approved health research (provided no patient-identifying data is published) or to cooperate with official financial/management audits and credentialing oversight agencies. All auditors must agree to return or destroy the data upon completion.
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Cause of Death Inquiries: We can share patient-identifying information with medical examiners, coroners, or funeral directors as required or allowed by laws relating to cause of death investigations.
Strict Rules for Legal Proceedings and Court Orders We must follow rigid, multi-layered procedures before using or sharing your information or providing testimony for investigations or legal proceedings.
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The Rule: We will not use or share your information, nor will we provide oral testimony about your records, in any civil, administrative, criminal, or legislative proceedings against you without your express written consent or a specialized Part 2 court order.
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The Subpoena Match: We will only respond to a court order to use or share your health information if it is accompanied by a subpoena or matching legal mandate requiring compliance.
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Notice and Opportunity to Be Heard: We will only share information in proceedings against you based on a court order after we have received formal notice and an opportunity to be heard, or after you have been properly notified of the legal action. You retain the explicit right to seek to overturn or modify any such court order after you learn about it.
Redisclosure and Stricter Pennsylvania Protections
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Redisclosure According to HIPAA: When you consent to disclosures for future treatment, payment, and operations, we may share information with other substance use programs, doctor offices, and health businesses. If the recipient is subject to HIPAA, they are permitted to use and share your information again without your consent for purposes that HIPAA allows. However, your data still cannot be used in legal investigations or proceedings against you without your consent or a specialized Part 2 court order and matching subpoena.
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Pennsylvania Mental Health Restrictions: In the Commonwealth of Pennsylvania, outpatient mental health and psychiatric records carry an enhanced baseline of legal protection. Even when HIPAA allows a standard medical disclosure, our practice will not share or release your psychological treatment charts or clinical summaries to any external party without your written consent unless it is directly for treatment coordination, authorized billing operations, or explicit state law mandates it (such as child abuse reporting or judge-signed orders).
Our Core Responsibilities
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We are required by law to maintain the privacy and security of your protected health information and substance use records.
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We must obtain your consent for most uses and sharing of your information.
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We will notify you promptly if a breach occurs that may have compromised the privacy or security of your data.
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We must follow the strict duties and privacy practices described in this notice and provide you with a copy of it.
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We will not use or share your information other than as described in this notice unless you tell us we can in writing. If you change your mind, you may revoke your consent in writing at any time.
Changes to the Terms of this Notice We are required to follow the terms of this notice currently in effect. We reserve the right to change the terms of this notice, and any changes will apply to all information we maintain about you. The revised notice will be made available upon request in our office, via our secure client portal, and posted on our website at www.greenzonecounseling.com.
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FOR MORE INFORMATION OR TO REPORT A PROBLEM
If you have questions about this notice or would like additional information, you may contact our Privacy Compliance Officer, Wesley McWilliams, at the telephone or address below. If you believe that your privacy rights have been violated, you have the right to file a complaint with the Privacy Officer at GreenZone Professional Counseling or with the Secretary of the Department of Health and Human Services. The complaint must be in writing, describe the acts or omissions that you believe violate your privacy rights, and be filed within 180 days of when you knew or should have known that the act or omission occurred. We will take no retaliatory action against you if you make such complaints.
The contact information for both is included below.
U.S. Department of Health and Human Services
Office of the Secretary
200 Independence Avenue, S.W.
Washington, D.C. 20201
Tel: (202) 619-0257
Toll Free: 1-877-696-6775
GreenZone Professional Counseling
Wesley McWilliams
Privacy Compliance Officer
111 Walker Drive, Suite A, Edinboro, PA 16412
Ph: (814) 734-0199
Fax: (814) 734-0196
NOTICE OF PRIVACY PRACTICES AVAILABILITY
You will have access to and be provided a digital copy at the time we first deliver services to you in your client portal. Thereafter, you may obtain a copy upon request, and the notice will be maintained on our website by clicking the downloadable PDF file here: Notice of Privacy Practices