SMS Privacy and Terms of use.

Onyx Counseling and Wellness LLC. 

11 Apex Drive. Suite 300A, Marlborough, MA, 01752, United States 

617-249-3577 

EFFECTIVE DATE OF THIS NOTICE This notice went into effect on 05/01/2025 

NOTICE OF PRIVACY PRACTICES 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 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. 

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. 

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. Although minimum necessary standard is not applied, disclosures for 

consultation will be limited, when possible, to providers within Onyx Counseling and Wellness 

LLC, who are bound by the same privacy laws as your provider. 

Lawsuits and Disputes: If you are involved in a lawsuit, I may disclose health information in 

response to a court or administrative order. I may also disclose health information about your 

child in response to a subpoena, discovery request, or other lawful process by someone else 

involved in the dispute, but only if efforts have been made to tell you about the request or to 

obtain an order protecting the information requested. 

III. CERTAIN USES AND DISCLOSURES REQUIRE YOUR AUTHORIZATION: 

1. Psychotherapy Notes. I do keep “psychotherapy notes” as that term is defined in 45 CFR 

§ 164.501, and any use or disclosure of such notes requires your Authorization unless the 

use or disclosure is: 

a. For my use in treating you. 

b. For my use in training or supervising mental health practitioners to help them improve their skills in group, joint, family, or individual counseling or therapy. 

c. For my use in defending myself in legal proceedings instituted by you. 

d. For use by the Secretary of Health and Human Services to investigate my compliance with HIPAA. e. Required by law and the use or disclosure is limited to the requirements of such law. f. Required by law for certain health oversight activities pertaining to the originator of the psychotherapy notes. 

g. Required by a coroner who is performing duties authorized by law.

h. Required to help avert a serious threat to the health and safety of others. 

2. Marketing Purposes. As a psychotherapist, I will NOT use or disclose your PHI for marketing purposes. 

3. 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: 

1. 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. 

2. 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. 

3. For health oversight activities, including audits and investigations. 

4. For judicial and administrative proceedings, including responding to a court or administrative order, although my preference is to obtain an Authorization from you before doing so. 

5. For law enforcement purposes, including reporting crimes occurring on my premises or person. 

6. To coroners or medical examiners, when such individuals are performing duties authorized by law. 

7. 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. We don’t conduct research generally and will inform you if that changes, request your consent to participate as well as comply with research ethics around sampling and confidentiality of participants. 

8. 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. This would be a HIGHLY unusual circumstance as a private company, however, we keep it here in the rare case that an individual receiving services somehow involve us in these matters. 

9. 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. This would only come into effect in the event of an incident between you and an employee of Onyx Counseling and Wellness or our property. 

10. Appointment reminders via Email/SMS/or Voice 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 or can refer you to. 

11. Additional measures to protect your privacy In addition to HIPAA, 42 CFR Part 2 stipulates additional requirements necessary in order to disclose your participation in substance use disorder treatment. If you are not receiving treatment for substance use disorder you can expect your PHI to be protected to the same standard. 

12. Notification and communication with family. Only with authorization/consent, or in the case of an emergency, may we disclose your health information to notify or assist in notifying a family member, your personal representative, or another person responsible for your care about your location, your general condition, or in the event of your death. In an emergency situation, including if you are transferred to another facility for medical or psychiatric reasons, we will give you the opportunity to object to notification of your 

family or personal representative. However, if you are unavailable or unable to agree or object due to medical or psychiatric reasons, our health professionals will use their best judgment in communication with your family and others. 

V. CERTAIN USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT. 

1. Disclosures to family, friends, or others. I may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations. 

VI. YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI: 

1. 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, or if it's required by applicable laws. 

2. The Right to Request Restrictions for Out-of-Pocket Expenses Paid for In Full. You have the right to request restrictions on disclosures of your PHI to health plans for payment or health care operations purposes if the PHI pertains solely to a health care item or a health care service that you have paid for out-of-pocket in full. 

3. 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, cell or office phone, email) or to send mail to a different address, and I will agree to all reasonable requests. 

4. The Right to See and Get Copies of Your PHI. Other than “psychotherapy 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. 

5. 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. 

6. 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. 

7. The Right to Get a Paper or Electronic Copy of this Notice. You have the right 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. 

Acknowledgement of Receipt of Privacy Notice 

Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), you have certain rights regarding the use and disclosure of your protected health information. By checking the box below, you are acknowledging that you have received a copy of HIPAA Notice of Privacy Practices.

BY SIGNING BELOW I AM AGREEING THAT I HAVE READ, UNDERSTOOD AND AGREE TO THE ITEMS CONTAINED IN THIS DOCUMENT.