Notice of Privacy Practices

CHAPMAN COUNSELING PLLC

Effective Date: October 5th, 2026

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

Chapman Counseling PLLC (“Chapman Counseling,” “we,” “us,” or “our”) is committed to protecting the privacy of your health information.

This Notice of Privacy Practices (“Notice”) describes how we may use and disclose your protected health information (“PHI”), your rights regarding your PHI, and our responsibilities regarding the privacy of your health information.

YOUR RIGHTS

You have the right to:

Obtain a Copy of Your Health Information

You generally have the right to inspect and obtain a copy of health information maintained by Chapman Counseling that may be used to make decisions about you.

You may request your records in paper or electronic form, subject to applicable law.

Request a Correction

You may ask us to correct health information that you believe is incorrect or incomplete.

We may deny a request in certain circumstances permitted by law, but we will provide you with an explanation of the denial.

Request Confidential Communications

You may ask us to communicate with you in a particular way or at a particular location.

For example, you may request that we contact you only by email, phone, or at a particular mailing address.

We will consider reasonable requests.

Request Restrictions

You may ask us to limit how we use or disclose your health information for treatment, payment, or healthcare operations.

We are not required to agree to every restriction request.

However, if you pay for a service or healthcare item completely out of pocket and request that we not disclose information relating to that service to your health insurer for payment or healthcare operations, we will generally honor that request unless disclosure is required by law.

Receive an Accounting of Certain Disclosures

You may request a list of certain disclosures of your health information made by Chapman Counseling during the applicable period required by law.

Certain disclosures are excluded from this accounting, including many disclosures made for treatment, payment, and healthcare operations.

Receive a Copy of This Notice

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

Choose Someone to Act for You

If you have given someone medical power of attorney or if someone is your legal guardian, that person may exercise your privacy rights on your behalf, subject to applicable law.

We will verify the person's authority before taking action.

File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with Chapman Counseling or with the U.S. Department of Health and Human Services Office for Civil Rights.

You will not be retaliated against for filing a privacy complaint.

OUR RESPONSIBILITIES

Chapman Counseling is required by law to:

Maintain the privacy of your protected health information;
Provide you with this Notice describing our legal duties and privacy practices;
Follow the terms of the Notice currently in effect;
Notify you as required by law if a breach occurs that compromises the privacy or security of your protected health information; and
Follow applicable federal and state privacy laws governing your health information.

We will not use or disclose your health information other than as described in this Notice or as otherwise permitted or required by law unless you provide written authorization.

If you provide written authorization, you may generally revoke that authorization in writing, except to the extent action has already been taken based upon it.

HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION

The following describes common circumstances in which we may use or disclose your health information.

Treatment

We may use or disclose health information to provide, coordinate, or manage your mental health treatment.

For example, we may communicate with another healthcare provider involved in your care when permitted by law.

Payment

Because Chapman Counseling operates as a self-pay practice, we generally do not submit claims to health insurance companies.

We may nevertheless use or disclose information as necessary to obtain payment for services, collect amounts owed, or otherwise conduct permitted payment activities.

Healthcare Operations

We may use or disclose health information as necessary for certain healthcare operations, including activities necessary to operate and manage our practice, improve the quality of services, maintain records, conduct administrative activities, and comply with applicable legal requirements.

Individuals Involved in Your Care

When permitted by law, we may disclose limited information to a family member, close friend, or another person involved in your care or payment for care when you agree or when the circumstances permit such disclosure.

Required by Law

We may use or disclose health information when required by federal, state, or local law.

Public Health

We may disclose health information for certain public health activities permitted or required by law.

Abuse, Neglect, or Domestic Violence

We may disclose information when required or permitted by law to report suspected abuse, neglect, or domestic violence.

Judicial and Administrative Proceedings

We may disclose health information in response to certain court orders, subpoenas, discovery requests, or other lawful processes when the requirements of applicable law are satisfied.

Law Enforcement

We may disclose health information to law enforcement when permitted or required by applicable law.

Serious Threats to Health or Safety

We may use or disclose information when necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public, when permitted by applicable law.

Workers' Compensation

We may disclose health information as authorized by and to the extent necessary to comply with laws relating to workers' compensation or similar programs.

Other Uses and Disclosures

Other uses and disclosures of your health information not described in this Notice will generally require your written authorization.

Certain particularly sensitive information may receive additional protection under federal or state law.

PSYCHOTHERAPY NOTES

Psychotherapy notes are subject to special federal privacy protections.

Where applicable, Chapman Counseling will obtain the authorization required by law before disclosing psychotherapy notes except where an applicable legal exception permits or requires disclosure without authorization.

Psychotherapy notes are distinct from information maintained in the ordinary clinical record.

SUBSTANCE USE DISORDER INFORMATION

Certain substance use disorder records may receive additional federal protection under 42 U.S.C. § 290dd-2 and 42 CFR Part 2.

Where applicable, Chapman Counseling will comply with the privacy and consent requirements governing such records.

YOUR AUTHORIZATION

Certain uses and disclosures of your health information require your written authorization.

For example, uses or disclosures of psychotherapy notes generally require authorization except where an exception applies.

You may revoke an authorization in writing as permitted by law. Revocation will not affect actions already taken in reliance upon the authorization.

SELF-PAY SERVICES

Chapman Counseling is a self-pay practice and does not routinely submit claims to health insurance.

If you pay completely out of pocket for a service and request that Chapman Counseling not disclose information relating to that service to your health plan for payment or healthcare operations purposes, Chapman Counseling will generally honor that request unless disclosure is required by law.

ELECTRONIC COMMUNICATIONS AND TELEHEALTH

Chapman Counseling may communicate with you electronically using methods that are appropriate for the particular communication.

Electronic communication, including email and text messaging, may carry privacy and security risks.

Telehealth services may involve the use of technology and third-party platforms. Chapman Counseling will use appropriate safeguards and platforms consistent with applicable privacy and security requirements.

You should avoid including unnecessary sensitive clinical information in ordinary email or text messages unless you have been instructed that the particular method is appropriate for that information.

MINORS AND PERSONAL REPRESENTATIVES

Privacy rights involving minors, parents, guardians, and personal representatives may be governed by applicable federal and New York law.

Chapman Counseling will determine the appropriate access and disclosure rights based on the circumstances and applicable law.

CHANGES TO THIS NOTICE

Chapman Counseling may change this Notice from time to time.

We reserve the right to make a revised Notice effective for health information we already maintain as well as information we receive in the future, to the extent permitted by law.

The current Notice will be available on our Website and upon request.

QUESTIONS OR PRIVACY COMPLAINTS

If you have questions about this Notice or believe your privacy rights have been violated, please contact:

Chapman Counseling PLLC
Privacy Contact: Michael Chapman - Owner
Email: michael@chapman-counseling.org
Telephone: 646-360-0141

You may also file a complaint with the:

U.S. Department of Health and Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Telephone: 1-877-696-6775

You may also obtain information about filing a complaint through the HHS Office for Civil Rights website.

Chapman Counseling will not retaliate against you for filing a complaint.