Notice of Privacy Practices
Mindful Pathways Counseling
Erica Westphal, MS, LMFT, PMH-C
380 Perry St. Suite 260 Castle Rock, CO 80104
(720) 541-4585
EFFECTIVE DATE OF THIS NOTICE
This notice went into effect on October 16, 2026.
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
I. MY PLEDGE REGARDING HEALTH INFORMATION:
I understand that health information about you and your health care is personal. I am committed to protecting health information about you. I create a record of the care and services you receive from me. I need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this mental health care practice. This notice will tell you about the ways in which I may use and disclose health information about you. I also describe your rights to the health information I keep about you, and describe certain obligations I have regarding the use and disclosure of your health information. I am required by law to:
Make sure that protected health information (“PHI”) that identifies you is kept private.
Give you this notice of my legal duties and privacy practices with respect to health information.
Follow the terms of the notice that is currently in effect.
I am also required by law to provide you with adequate notice of your rights and my legal duties if I create or maintain records protected by 42 C.F.R. Part 2.
I can change the terms of this Notice, and such changes will apply to all information I have about you. The new Notice will be available upon request, in my office, and on my website.
Notify affected individuals following a breach of unsecured protected health information when notification is required by applicable law.
II. HOW I MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU:
The following categories describe different ways that I use and disclose health information. For each category of uses or disclosures I will explain what I mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways I am permitted to use and disclose information will fall within one of the categories.
For Treatment, Payment, or Health Care Operations: Federal privacy rules (regulations) allow health care providers who have direct treatment relationship with the patient/client to use or disclose the patient/client’s personal health information without the patient’s written authorization, to carry out the health care provider’s own treatment, payment or health care operations. I may also disclose your protected health information for the treatment activities of any health care provider. This too can be done without your written authorization. For example, if a clinician were to consult with another licensed health care provider about your condition, we would be permitted to use and disclose your personal health information, which is otherwise confidential, in order to assist the clinician in diagnosis and treatment of your mental health condition.
Payment and Health Care Operations. I may use and disclose your protected health information as permitted by applicable law to collect payment for services and carry out routine practice operations. For example, payment activities may include processing payments for therapy sessions or preparing superbills at your request. Health care operations may include activities such as maintaining records, conducting quality improvement activities, and obtaining professional or administrative support necessary to operate the practice. I limit disclosures to what is permitted by applicable privacy and confidentiality laws.
If I receive or maintain substance use disorder treatment records protected by 42 CFR Part 2, I will handle those records according to applicable federal confidentiality requirements. Such records may not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you without your written consent or the court order and subpoena required by law. Other uses and disclosures will be subject to applicable consent requirements and legal exceptions.
Disclosures for treatment purposes are not limited to the minimum necessary standard. Because therapists and other health care providers need access to the full record and/or full and complete information in order to provide quality care. The word “treatment” includes, among other things, the coordination and management of health care providers with a third party, consultations between health care providers and referrals of a patient for health care from one health care provider to another.
Lawsuits and Disputes. If your health information is requested in connection with a lawsuit, subpoena, court order, or other legal proceeding, I will review the request and applicable legal requirements before disclosing any information. Mental health treatment records may be protected by confidentiality and privilege laws, including Colorado law. I will obtain your written authorization when required and will disclose information without your authorization only when permitted or required by applicable law. Records protected by 42 CFR Part 2 may be subject to additional restrictions on their use or disclosure in legal proceedings.
Colorado Mental Health Confidentiality. As a licensed marriage and family therapist in Colorado, I am subject to additional state confidentiality requirements. I will not disclose confidential communications made during therapy without your consent except when disclosure is permitted or required by applicable law, including the exceptions provided under Colorado Revised Statutes § 12-245-220.
III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION:
Other Uses and Disclosures Requiring Authorization. Uses and disclosures of your protected health information that are not described in this Notice or otherwise permitted or required by law will be made only with your written authorization. You may revoke a written authorization at any time by notifying me in writing. Revocation will not affect any use or disclosure already made in reliance on your authorization.
Psychotherapy Notes. I maintain clinical progress notes as part of your treatment record. I do not currently maintain separate psychotherapy notes as defined by 45 CFR § 164.501. If I begin maintaining separate psychotherapy notes in the future, their use or disclosure will generally require your written authorization, subject to exceptions permitted or required by law.
Substance Use Disorder (SUD) Counseling Notes. I do not currently maintain separate SUD counseling notes as defined under 42 CFR Part 2. Substance use concerns may be addressed as part of general psychotherapy and documented in your clinical treatment record. If I begin maintaining SUD counseling notes subject to 42 CFR Part 2 in the future, I will follow the applicable requirements for their use and disclosure, including obtaining separate written consent when required.
Marketing Purposes. As a psychotherapist, I will not use or disclose your PHI for marketing purposes.
Sale of PHI. As a psychotherapist, I will not sell your PHI in the regular course of my business.
IV. CERTAIN USES AND DISCLOSURES DO NOT REQUIRE YOUR AUTHORIZATION:
Subject to certain limitations in the law, I can use and disclose your PHI without your Authorization for the following reasons:
When disclosure is required by state or federal law, and the use or disclosure complies with and is limited to the relevant requirements of such law.
For public health activities, including reporting suspected child, elder, or dependent adult abuse, or preventing or reducing a serious threat to anyone’s health or safety.
For health oversight activities, including audits and investigations.
Judicial and Administrative Proceedings. I may disclose protected health information in response to a court order or other legal process only when the disclosure is permitted or required by applicable law. Before disclosing information, I will review the request and consider applicable confidentiality and privilege protections, including those provided under Colorado law. A subpoena does not automatically authorize the release of confidential therapy records.
For law enforcement purposes, including reporting crimes occurring on my premises.
To coroners or medical examiners, when such individuals are performing duties authorized by law.
For research purposes, including studying and comparing the mental health of patients who received one form of therapy versus those who received another form of therapy for the same condition.
Specialized government functions, including ensuring the proper execution of military missions; protecting the President of the United States; conducting intelligence or counter-intelligence operations; or helping to ensure the safety of those working within or housed in correctional institutions.
For workers’ compensation purposes. Although my preference is to obtain an Authorization from you, I may provide your PHI in order to comply with workers’ compensation laws.
Appointment reminders and health related benefits or services. I may use and disclose your PHI to contact you to remind you that you have an appointment with me. I may also use and disclose your PHI to tell you about treatment alternatives, or other health care services or benefits that I offer.
V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT:
Disclosures to Family Members, Friends, or Others Involved in Your Care. With your agreement, or when otherwise permitted by law, I may share information relevant to your care or payment for your care with a family member, friend, or another person involved in supporting you. When appropriate, you will have an opportunity to agree to or object to such disclosures. In certain circumstances, such as an emergency, information may be shared as permitted by applicable law. Additional confidentiality protections may apply under Colorado law.
Fundraising. If I intend to use or disclose your records protected by 42 C.F.R. Part 2 for fundraising for my benefit, I will provide you with a clear and conspicuous opportunity to opt-out before any such use or disclosure occurs.
VI. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI:
The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right to ask me not to use or disclose certain PHI for treatment, payment, or health care operations purposes. I am not required to agree to your request, and I may say “no” if I believe it would affect your health care.
The Right to Restrict Disclosures to Health Plans When Paying Out of Pocket. If you pay out of pocket in full for a health care service, you have the right to request that I not disclose information about that service to your health insurance plan for payment or health care operations purposes. I am required to honor this request unless the disclosure is required by law.
The Right to Choose How I Send PHI to You. You have the right to ask me to contact you in a specific way (for example, home or office phone), or to send mail to a different address, and I will agree to all reasonable requests.
The Right to See and Get Copies of Your PHI. Other than “psychotherapy notes” and “SUD counseling notes” you have the right to get an electronic or paper copy of your medical record and other information that I have about you. I will provide you with a copy of your record, or a summary of it, if you agree to receive a summary, within 30 days of receiving your written request, and I may charge a reasonable, cost-based fee for doing so.
The Right to Get a List of the Disclosures I Have Made. You have the right to request a list of instances in which I have disclosed your PHI for purposes other than treatment, payment, or health care operations, or for which you provided me with an Authorization. I will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list I will give you will include disclosures made in the last six years unless you request a shorter time. I will provide the list to you at no charge, but if you make more than one request in the same year, I will charge you a reasonable cost-based fee for each additional request. You also have the right to request an accounting of disclosures specifically for your substance use disorder records protected under 42 C.F.R. Part 2.
The Right to Correct or Update Your PHI. If you believe that there is a mistake in your PHI, or that a piece of important information is missing from your PHI, you have the right to request that I correct the existing information or add the missing information. I may say “no” to your request, but I will tell you why in writing within 60 days of receiving your request.
The Right to Get a Paper or Electronic Copy of this Notice. You have the right to get a paper copy of this Notice, and you have the right to get a copy of this notice by e-mail. And, even if you have agreed to receive this Notice via e-mail, you also have the right to request a paper copy of it.
The Right to Be Notified of a Breach. You have the right to receive notification if a breach of your unsecured protected health information occurs and notification is required under applicable law.
The Right to Have an Authorized Personal Representative. If someone has legal authority to act on your behalf regarding your health information, such as a legally authorized guardian or a person holding an applicable medical power of attorney, that person may exercise your privacy rights as permitted by law. I will verify their authority before allowing access to your information or accepting instructions on your behalf.
VII. QUESTIONS OR COMPLAINTS ABOUT PRIVACY
If you have questions about this Notice of Privacy Practices, your privacy rights, or how your health information is handled, please contact:
Erica Westphal, MS, LMFT, PMH-C
Privacy Contact, Mindful Pathways Counseling
Phone: (720) 541-4585
Email: erica@mindfulpathwaysco.comIf you believe your privacy rights have been violated, you may file a complaint with Mindful Pathways Counseling or with the U.S. Department of Health and Human Services, Office for Civil Rights (OCR).
You can submit a complaint to OCR at https://www.hhs.gov/ocr/complaints/index.html.
You will not be retaliated against for filing a privacy complaint.
ACKNOWLEDGMENT OF RECEIPT
By signing below, I acknowledge that I have received a copy of Mindful Pathways Counseling's Notice of Privacy Practices. My signature acknowledges receipt of this notice and does not constitute consent to uses or disclosures of my health information that otherwise require separate authorization.