HIPAA Notice of Privacy Practices

A brightly lit therapy room with a couch, chair, and plants in East Lansing, Michigan
I prioritize your privacy both online and in our East Lansing, MI therapy office

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.

Effective Date: [5/1/26]

1. Our Duty to Safeguard Your Protected Health Information (PHI) Schafer Consulting LLC is required by federal and state law (including the Health Insurance Portability and Accountability Act - HIPAA) to maintain the privacy of your Protected Health Information (PHI). PHI includes information about your physical or mental health condition, the mental health care provided to you, and payment for your care.

2. How I May Use and Disclose Your PHI I may use or disclose your PHI for the following standard purposes with your written authorization on my Consent to Treatment form:

  • Treatment: To provide, coordinate, or manage your psychological treatment. (e.g., consulting with my supervisor).
  • Payment: To bill and collect payment for the services provided to you.
  • Healthcare Operations: For internal administrative activities, quality assessment, and ensuring compliance with licensing regulations.
  • Telehealth: I provide telehealth services across the state of Michigan using HIPAA-compliant platforms designed to protect your privacy and data security during virtual sessions.

3. Uses and Disclosures Requiring Your Authorization For any purposes outside of Treatment, Payment, or Healthcare Operations, I will only use or disclose your PHI with your specific, written authorization. You may revoke this authorization at any time in writing.

4. Exceptions to Confidentiality State and federal laws mandate that I break confidentiality and disclose PHI in specific, limited situations, including:

  • If there is a serious and imminent threat to your safety or the safety of another person.
  • Suspected child abuse, elder abuse, or neglect.
  • If required by a valid court order or subpoena.

5. Your Rights Regarding Your PHI You have the following rights regarding the PHI we maintain about you:

  • Right to Access: You have the right to inspect and receive a copy of your medical and billing records.
  • Right to Amend: You may request corrections to your PHI if you believe it is inaccurate or incomplete.
  • Right to an Accounting of Disclosures: You can request a list of certain instances where we disclosed your PHI.
  • Right to Request Restrictions: You can ask us not to use or disclose certain parts of your PHI for treatment, payment, or healthcare operations. We will consider your request but are not legally required to agree to it.
  • Right to Confidential Communications: You can request that we communicate with you about health matters in a specific way (e.g., only calling your cell phone).

6. Complaints If you believe your privacy rights have been violated, you may file a complaint with our office directly or with the Secretary of the Department of Health and Human Services (HHS). You will not be penalized for filing a complaint.

Contact Person for Privacy Issues: Andrew Schafer, Master's Level Psychologist, Schafer Consulting LLC, 808 W Lake Lansing Suite 200 East Lansing MI 48823, (734) 778-2467