Notice of Privacy Practices
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.
I. OUR PLEDGE REGARDING HEALTH INFORMATION
We understand that health information about you and your care is personal. Beckham Counseling LLC is committed to protecting health information about you. We create a record of the care and services you receive to provide quality care and to comply with legal and ethical requirements.
This Notice applies to all records generated by this mental health practice. It outlines how we may use and disclose your Protected Health Information (PHI), details your privacy rights, and describes our legal obligations.
Under federal (HIPAA) and Florida law, we are required to:
Ensure that PHI that identifies you is kept private.
Provide you with this Notice of our legal duties and privacy practices with respect to your PHI.
Notify you promptly following any breach of your unsecured PHI.
Follow the terms of the Notice currently in effect.
We reserve the right to change the terms of this Notice at any time. Revised terms will apply to all PHI we maintain. Updated notices will be posted on our website (beckhamcounseling.com) and made available upon request.
II. HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
Federal regulations allow healthcare providers with a direct treatment relationship to use or disclose PHI without your written authorization for Treatment, Payment, and Healthcare Operations:
Treatment: We may use and disclose your PHI to coordinate or manage your mental health care. For example, we may consult with another licensed healthcare provider (such as a psychiatrist, primary physician, or consulting clinician) to assist in diagnosis and treatment.
Payment: We may use and disclose your PHI to bill and collect payment from you, your health insurance plan, or third parties (including issuing superbills for out-of-network reimbursement).
Healthcare Operations: We may use and disclose PHI to run our practice, ensure quality of care, conduct administrative operations, and fulfill legal compliance functions.
III. USES AND DISCLOSURES REQUIRING YOUR EXPLICIT WRITTEN AUTHORIZATION
For disclosures outside of routine Treatment, Payment, or Operations, we will obtain your explicit written authorization. You may revoke an authorization in writing at any time.
Psychotherapy Notes: We maintain separate "psychotherapy notes" as defined in 45 CFR § 164.501. Any release of psychotherapy notes requires a separate, signed authorization, except:
For our own use in treating you.
For our defense in legal proceedings instituted by you.
For investigations by the Secretary of Health and Human Services (HHS).
As required by law or health oversight activities related to the originator of the notes.
Marketing & Sale of PHI: We will never sell your PHI or use your health information for marketing or advertising purposes.
IV. USES AND DISCLOSURES THAT DO NOT REQUIRE YOUR AUTHORIZATION
Subject to state and federal limits, we may disclose your PHI without your authorization under the following specific circumstances:
Child, Elder, or Vulnerable Adult Abuse: Florida law mandates reporting to the Florida Department of Children and Families (DCF) if there is reasonable cause to suspect abuse, neglect, or abandonment of a child, elderly adult, or vulnerable adult.
Serious Threat to Health or Safety: Disclosure necessary to prevent or lessen a serious, imminent threat to your health or safety, or the safety of another person or the public (duty to protect/warn).
Judicial and Administrative Proceedings: If you are involved in a court proceeding, PHI may be disclosed in response to a direct court order. In Florida, a subpoena signed solely by an attorney does not automatically compel the release of confidential mental health records without your signed release or a judge's order.
Health Oversight Activities: Disclosures required by government agencies or the Florida Department of Health for audits, investigations, or licensure oversight.
Law Enforcement & Public Safety: Disclosures necessary to report crimes occurring on office premises or to avert imminent danger.
Workers' Compensation: Disclosures required to comply with Florida workers' compensation laws.
Appointment Reminders: We may contact you via email, phone, or text (via secure systems) to remind you of scheduled appointments.
V. OPPORTUNITY TO OBJECT
Disclosures to Family or Friends: We may disclose PHI to a family member, close friend, or personal representative involved in your care or payment for care if you verbally agree, or if we determine through clinical judgment in an emergency situation that it is in your best interest.
VI. YOUR RIGHTS REGARDING YOUR PHI
Right to Request Restrictions: You may ask us to limit how we use or disclose your PHI for treatment, payment, or operations. We are not required to agree unless you request that we not disclose PHI to a health plan for services paid entirely out-of-pocket in full.
Right to Confidential Communications: You may request that we communicate with you in a specific way (e.g., calling a specific phone number or emailing a designated address). Reasonable requests will be accommodated.
Right to Inspect and Copy: You have the right to inspect and obtain an electronic or paper copy of your clinical and billing records (excluding psychotherapy notes). Requests will be fulfilled within 30 days. Under Florida law, reasonable cost-based fees for copying or records preparation may apply.
Right to Amend: If you feel information in your record is incorrect or incomplete, you may request an amendment in writing. If we deny your request, we will provide a written explanation within 60 days.
Right to an Accounting of Disclosures: You may request a list of non-routine disclosures of your PHI made in the past six years. The first accounting within a 12-month period is free; subsequent requests may incur a reasonable fee.
Right to Paper or Electronic Copy: You have the right to receive a copy of this Notice at any time via paper or email upon request.
VII. RECORD RETENTION
In compliance with Florida Board of Clinical Social Work, Marriage & Family Therapy and Mental Health Counseling rules, clinical records are securely maintained for a minimum of seven (7) years following the last date of professional service.
VIII. COMPLAINTS AND CONTACT INFORMATION
If you believe your privacy rights have been violated, you may file a written complaint with our practice or with the U.S. Department of Health and Human Services Office for Civil Rights. You will not be penalized or retaliated against for filing a complaint.
Practice Privacy Officer:
R. Matt Beckham, LMHC
Beckham Counseling LLC
2431 Aloma Ave Ste 124, Winter Park, FL 32792
Email: matt@beckhamcounseling.com
Phone: 407-617-3409
U.S. Department of Health and Human Services (OCR):
Office for Civil Rights — Region IV
Website: www.hhs.gov/ocr/privacy/hipaa/complaints
Effective Date: October 2, 2026