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: June 11, 2026

Our Commitment to Your Privacy

At KC Counseling Group, we understand that your mental health information is deeply personal. We are required by law to maintain the privacy and security of your Protected Health Information (PHI). We are also required to provide you with this notice of our legal duties and privacy practices, and to abide by the terms of the notice currently in effect.

How We May Use and Disclose Your Health Information

We typically use or share your health information in the following ways:

For Treatment: We can use your health information and share it with other professionals who are treating you.

• Internal Practice Coordination: A clinician at our practice may discuss your care with another counselor within the group to coordinate your treatment plan.
• Supervision and Provisional Licenses: All clinical interns under supervision and provisionally licensed professionals within our practice will conduct regular clinical consultations regarding your care directly with their assigned supervisor.
• Outside Consultations: Should a therapist choose to seek clinical consultation outside of this practice for professional guidance, no identifying information whatsoever will be shared. The case details will remain completely anonymous to protect your privacy.

For Health Care Operations: We can use and share your health information to run our practice, improve your care, and contact you when necessary. Example: We use health information about you to manage your services and audit our clinical performance.

For Payment: We can use and share your health information to bill and get payment from health plans or other entities. Example: We give information about you to your health insurance plan so it will pay for your counseling sessions.

Uses and Disclosures That Require Your Written Authorization

For standard clinical data, we need your explicit written permission for anything outside of treatment, payment, or healthcare operations.

Psychotherapy Notes: Any notes your counselor takes during a private session that are kept separate from the rest of your medical record face heightened protections. We will never share these notes without your explicit written authorization, except in highly limited circumstances permitted by law (such as preventing a serious, imminent threat to health or safety).

Marketing and Sale of Information: We will never sell your information or use it for marketing purposes.

Revoking Authorization: If you do give us authorization, you can change your mind and revoke it in writing at any time, except to the extent that we have already acted on it.

Special Notice Regarding Substance Use Disorder (SUD) Records: To the extent that KC Counseling Group creates or maintains substance use disorder patient records subject to federal regulations (42 CFR Part 2), these records enjoy stricter protections than standard HIPAA data. We cannot use or disclose these records in civil, criminal, administrative, or legislative proceedings against you without your written consent or a specific court order. If we intend to use any such records for fundraising, you have a clear right to opt out completely.

Other Permitted Uses and Disclosures (Without Your Authorization)

We are allowed or required to share your information in other ways, usually in ways that contribute to the public good, such as public health and safety. We have to meet many conditions in the law before we can share your information for these purposes:

Averting a Serious Threat to Health or Safety: We may use or disclose your PHI if we believe it is necessary to prevent or lessen a serious and imminent threat to your health and safety or the safety of the public.

Abuse and Neglect: We are legally mandated reporters. We must disclose information to report suspected child, elder, or dependent adult abuse or neglect.

Law Enforcement and Legal Proceedings: We may share health information for law enforcement purposes or in response to a valid court order or administrative order.

Workers’ Compensation: We can use or share health information about you for workers’ compensation claims.

Your Rights Regarding Your Health Information

When it comes to your health information, you have certain distinct rights:

Get an Electrical Copy of Your Record: You can ask to see or get an electrical (electronic) copy of your medical record and other health information we have about you. We will provide a secure electrical copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee for data delivery.

Ask Us to Correct Your Record: You can ask us to correct health information about you that you think is incorrect or incomplete. We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request Confidential Communications: You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.

Ask Us to Limit What We Use or Share: You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care. If you pay for a service completely out-of-pocket, you can ask us not to share that information with your health insurer for the purpose of payment or healthcare operations. We will say “yes” unless a law requires us to share that information.

Get a List of Those With Whom We’ve Shared Information: You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make).

Get a Copy of This Privacy Notice: You can ask for a copy of this notice at any time, even if you have agreed to receive the notice electrically.

Right to Notice of a Breach: You have the right to be notified promptly if a breach occurs that may have compromised the privacy or security of your unsecured information.

Potential for Redisclosure: Please note that once information is legitimately disclosed pursuant to your authorization or under allowed rules, it may potentially be subject to redisclosure by the recipient and may no longer be protected by federal privacy rules.

Changes to the Terms of This Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and prominently posted on our website.

Complaints and Contact Information

If you believe your privacy rights have been violated, you can file a complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights. We will not retaliate against you for filing a complaint.

To file a complaint with our practice, or if you have any questions about this notice, please contact our designated Privacy Officer:

Privacy Officer / Compliance Contact
KC Counseling Group
Mailing Address: 905 Northeast Rice Rd., Lee’s Summit, MO 64063
Phone: 816-678-1770