Instilling Hope, Finding Resolution
Prescott, AZ & Online
Cornerstone Counseling Services of Arizona DBA Streamline Professional Counseling (the “Practice”) is committed to protecting your privacy. The Practice is required by federal law to maintain the privacy of Protected Health Information (“PHI”), which is information that identifies or could be used to identify you. The Practice is required to provide you with this Notice of Privacy Practices (this “Notice”), which explains the Practice's legal duties and privacy practices and your rights regarding PHI that we collect and maintain.
Your rights regarding PHI are explained below. To exercise these rights, please submit a written request to the Practice at the address noted below.
Privacy Disclaimer
We respect your privacy and are committed to protecting your personal information. We will not use, share, or disclose your data without your explicit consent, except where required by law.
If you have any questions or concerns regarding your privacy, please contact Cornerstone Counseling Services of Arizona DBA Streamline Professional Counseling at 928-232-0168.
Clients can opt in to receive SMS messages from Cornerstone Counseling Services of Arizona DBA Streamline Professional Counseling from the phone number 928-232-0168 using the following methods:
Message frequency varies based on client needs, with an estimated 1-4 messages per month.
Message & data rates may apply.
Reply HELP for help
STOP to opt out anytime
View our Privacy Policy: https://www.streamlinecounseling.org/our-privacy-policy.
Clients may opt out of SMS messages at any time by replying STOP to any message. After opting out, no further messages will be sent unless they opt in again.
HIPAA Privacy Notice
We are committed to protecting your privacy and complying with the Health Insurance Portability and Accountability Act (HIPAA). Any personal health information (PHI) you provide will be kept confidential and used only for the purposes of providing services, processing payments, or as otherwise required by law.
You have the right to:
✔ Access and obtain a copy of your health records.
✔ Request corrections to your records if you believe there are errors.
✔ Request restrictions on certain uses and disclosures of your information.
✔ Receive an accounting of disclosures made outside of treatment, payment, or healthcare operations.
✔ File a complaint if you believe your rights have been violated.
If you have any questions about this privacy notice or wish to exercise your rights under HIPAA, please contact us at: (928) 232-0168
To inspect and copy PHI.
• You can ask for an electronic or paper copy of PHI. The Practice may charge you a reasonable fee.
• The Practice may deny your request if it believes the disclosure will endanger your life or another person's life. You may have a right to have this decision reviewed.
To amend PHI.
• You can ask to correct PHI you believe is incorrect or incomplete. The Practice may require you to make your request in writing and provide a reason for the request.
• The Practice may deny your request. The Practice will send a written explanation for the denial and allow you to submit a written statement of disagreement.
To request confidential communications.
• You can ask the Practice to contact you in a specific way. The Practice will say “yes” to all reasonable requests.
To limit what is used or shared.
• You can ask the Practice not to use or share PHI for treatment, payment, or business operations. The Practice is not required to agree if it would affect your care.
• If you pay for a service or health care item out-of-pocket in full, you can ask the Practice not to share PHI with your health insurer.
• You can ask the Practice not to share your PHI with family members or friends by stating the specific restriction requested and to whom you want the restriction to apply.
To obtain a list of those with whom your PHI has been shared.
• You can ask for a list, called an accounting, of the times your health information has been shared. You can receive one accounting every 12 months at no charge, but you may be charged a reasonable fee if you ask for one more frequently.
To receive a copy of this Notice.
• You can ask for a paper copy of this Notice, even if you agree to receive the Notice electronically.
To choose someone to act for you.
• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights.
To file a complaint if you feel your rights are violated.
• You can file a complaint by contacting the Practice using the following information:
Streamline Professional Counseling
623 Miller Valley Rd. Suite B Prescott, AZ 86301
Scott Kerr
928-232-0168
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
• The Practice will not retaliate against you for filing a complaint.
To opt out of receiving fundraising communications.
• The Practice may contact you for fundraising efforts, but you can ask not to be contacted again.
1. Routine Uses and Disclosures of PHI
The Practice is permitted under federal law to use and disclose PHI, without your written authorization, for certain routine uses and disclosures, such as those made for treatment, payment, and the operation of our business. The Practice typically uses or shares your health information in the following ways:
To treat you.
• The Practice can use and share PHI with other professionals who are treating you.
• Example: Your primary care doctor asks about your mental health treatment.
To run the health care operations.
• The Practice can use and share PHI to run the business, improve your care, and contact you.
• Example: The Practice uses PHI to send you appointment reminders if you choose.
To bill for your services.
• The Practice can use and share PHI to bill and get payment from health plans or other entities.
• Example: The Practice gives PHI to your health insurance plan so it will pay for your services.
2. Uses and Disclosures of PHI That May Be Made Without Your Authorization or Opportunity to Object
The Practice may use or disclose PHI without your authorization or an opportunity for you to object, including:
To help with public health and safety issues
• Public health: To prevent the spread of disease, assist in product recalls, and report adverse reactions to medication.
• Required by the Secretary of Health and Human Services: We may be required to disclose your PHI to the Secretary of Health and Human Services to investigate or determine our compliance with the requirements of the final rule on Standards for Privacy of Individually Identifiable Health Information.
• Health oversight: For audits, investigations, and inspections by government agencies that oversee the health care system, government benefit programs, other government regulatory programs, and civil rights laws.
• Serious threat to health or safety: To prevent a serious and imminent threat.
• Abuse or Neglect: To report abuse, neglect, or domestic violence.
To comply with law, law enforcement, or other government requests
• Required by law: If required by federal, state, or local law.
• Judicial and administrative proceedings: To respond to a court order, subpoena, or discovery request.
• Law enforcement: For law locate and identify you or disclose information about a victim of a crime.
• Specialized Government Functions: For military or national security concerns, including intelligence, protective services for heads of state, or your security clearance.
• National security and intelligence activities: For intelligence, counterintelligence, protection of the President, other authorized persons, or foreign heads of state, for the purpose of determining your own security clearance and other national security activities authorized by law.
• Workers' Compensation: To comply with workers' compensation laws or support claims.
To comply with other requests
• Coroners and Funeral Directors: To perform their legally authorized duties.
• Organ Donation: For organ donation or transplantation.
• Research: For research that has been approved by an institutional review board.
• Inmates: The Practice created or received your PHI in the course of providing care.
• Business Associates: To organizations that perform functions, activities, or services on our behalf.
3. Uses and Disclosures of PHI That May Be Made With Your Authorization or Opportunity to Object
Unless you object, the Practice may disclose PHI:
To your family, friends, or others if PHI directly relates to that person's involvement in your care.
If it is in your best interest you are unable to state your preference.
4. Uses and Disclosures of PHI Based Upon Your Written Authorization
The Practice must obtain your written authorization to use and/or disclose PHI for the following purposes:
Marketing, sale of PHI, and psychotherapy notes.
You may revoke your authorization, at any time, by contacting the Practice in writing, using the information above. The Practice will not use or share PHI other than as described in the Notice unless you give your permission in writing.
• The Practice is required by law to maintain the privacy and security of PHI.
• The Practice is required to abide by the terms of this Notice currently in effect. Where more stringent state or federal law governs PHI, the Practice will abide by the more stringent law.
• The Practice reserves the right to amend the Notice. All changes are applicable to PHI collected and maintained by the Practice. Should the Practice make changes, you may obtain a revised Notice by requesting a copy from the Practice, using the information above, or by viewing a copy on the website [WEB ADDRESS WHERE THIS NOTICE IS POSTD].
• The Practice will inform you if PHI is compromised in a breach.
This Notice is effective on 12/01/2021.
At Cornerstone Counseling Services of Arizona DBA Streamline Professional Counseling, we value your privacy and are committed to protecting your personal information. By opting into our text messaging service, you agree to the following terms:
We will only use your phone number to send you appointment reminders, scheduling updates, and responses to your inquiries. No promotional or marketing messages will be sent.
Clients can opt in to receive SMS messages from Cornerstone Counseling Services of Arizona DBA Streamline Professional Counseling from the phone number 928-232-0168 using the following methods:
Message frequency varies based on client needs, with an estimated 1-4 messages per month.
Message & data rates may apply.
Reply HELP for help
STOP to opt out anytime
View our Privacy Policy: https://www.streamlinecounseling.org/our-privacy-policy.
Clients may opt out at any time by replying STOP to any message. After opting out, no further messages will be sent unless they opt in again.
Standard message and data rates may apply based on your mobile carrier.
We do not sell, share, or distribute mobile numbers to third parties for marketing or promotional purposes. All opt-in data and consent are never shared.
For assistance, reply HELP to any text message or contact us at streamlinecounseling@gmail.com or (928) 232-0168.
While we prioritize protecting your data, text messaging is not 100% secure. Please avoid sharing sensitive personal or financial information via SMS.
By opting into our SMS service, you acknowledge and agree to these terms. For more information, visit our Privacy Policy & Terms and Conditions at: https://www.streamlinecounseling.org/our-privacy-practices
By opting into text messaging from Cornerstone Counseling Services of Arizona DBA Streamline Professional Counseling, you agree to the following terms:
By providing your mobile phone number, you consent to receive appointment reminders, scheduling updates, and responses to your inquiries via SMS from Cornerstone Counseling Services of Arizona DBA Streamline Professional Counseling. No marketing or promotional messages will be sent.
Message frequency varies based on client communication needs (typically 1-2 messages per month).
Clients can opt out of SMS messages at any time by replying STOP to any message. A final confirmation message will be sent, and no further messages will be sent unless the client opts in again.
Standard message and data rates may apply based on your mobile carrier.
Your privacy is important to us. We do not share, sell, or distribute mobile phone numbers with third parties for marketing purposes. All opt-in consent data is kept confidential and will not be shared.
By using our text messaging service, you confirm that you are at least 18 years of age or have parental/guardian consent.
Cornerstone Counseling Services of Arizona DBA Streamline Professional Counseling is not responsible for delayed or undelivered messages due to factors outside our control, such as carrier issues or service interruptions.
We reserve the right to modify or terminate SMS services at any time. Any changes will be communicated via our website or text message.
For assistance, reply HELP to any text message or contact us at streamlinecounseling@gmail.com or (928) 232-0168.
By opting in, you confirm that you have read and agree to these terms. For more details, visit: https://www.streamlinecounseling.org/our-privacy-practices
Opt-In to receive SMS messages from Streamline Professional Counseling, text
(928) 232-0168.
Serving the State of Arizona
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