Effective as of January 22, 2026
THIS NOTICE DESCRIBES HOW MENTAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Your Rights
- Get an electronic or paper copy of your record
- Request corrections to certain records
- Request confidential communication
Our Uses
- Treat you (clinical care)
- Bill for your services
- Run our organization
Our Duties
- Maintain the privacy of your PHI
- Notify you if a breach occurs
- Never sell your PHI and do not use it for marketing purposes without your written authorization
Our Commitment to Your Privacy
Evolve Therapy & Counseling (“we,” “our,” or the “Practice”) is committed to protecting the privacy of your protected health information (“PHI”).
We are required by law to:
- Maintain the privacy of your PHI
- Provide you with this Notice of our legal duties and privacy practices
- Follow the terms of this Notice currently in effect
This Notice applies to services provided by Evolve Therapy & Counseling at our Florida locations and through telehealth services.
How We May Use and Disclose Your Health Information
1) For Treatment
We may use and disclose your PHI to provide, coordinate, or manage your mental health care. This includes communication between therapists, clinical supervisors,
and other healthcare professionals involved in your treatment.
Examples include psychotherapy services, trauma-focused therapy, addiction counseling, assessment, diagnosis, treatment planning, and continuity of care.
2) For Payment
We may use and disclose PHI to bill and collect payment for services you receive. This may include disclosures to insurance companies, billing services, or other third-party payers.
3) For Healthcare Operations
We may use and disclose PHI for business operations such as:
- Quality assessment and improvement
- Clinical supervision and training, oversight, and quality assurance purposes in accordance with Florida licensing requirements.
- Licensing, accreditation, and credentialing
- Compliance, audits, and administrative activities
4) Appointment Reminders & Communication
We may contact you to remind you of appointments or coordinate care-related services, including treatment-related services, via phone, email, or text message, unless you request otherwise.
5) As Required by Law
We may disclose PHI when required to do so by federal, state, or local law, including court orders or legal processes.
6) Public Health & Safety
We may disclose PHI to prevent or lessen a serious and imminent threat to your health or safety or the safety of others, consistent with applicable law and ethical standards.
7) Abuse, Neglect, or Domestic Violence
We may disclose PHI to appropriate authorities if we reasonably believe you are a victim of abuse, neglect, or domestic violence, as required or permitted by law. Per Florida Statutes (Chapter 39 and 415), we are mandatory reporters. If we have reasonable cause to suspect that a child, elder, or vulnerable adult is being abused, neglected, or abandoned, we must report this immediately to the Florida Abuse Hotline (1-800-96-ABUSE).
8) Health Oversight Activities
We may disclose PHI to health oversight agencies for activities authorized by law, such as investigations, inspections, and licensing reviews.
9) Telehealth Services
PHI may be used and disclosed in connection with teletherapy services using secure electronic platforms. We use secure electronic platforms designed to protect your information in accordance with applicable privacy and security standards.
10) With Your Authorization
Any use or disclosure of PHI not described in this Notice will be made only with your written authorization. You may revoke such authorization at any time in writing. We will never sell your PHI or use it for marketing purposes without your express written permission.
11) Reproductive Health Care Privacy
We are prohibited from using or disclosing your protected health information (PHI) for the purpose of investigating or imposing liability on any person for the mere act of seeking, obtaining, providing, or facilitating lawful reproductive health care. We will not disclose PHI to identify any person for these prohibited purposes. For certain requests for PHI that are not for treatment, payment, or healthcare operations, we may require a signed attestation from the requester confirming that the information will not be used for these prohibited purposes.
Special Protections for Mental Health Information
Psychotherapy notes are afforded additional protection under federal law and are not disclosed without your explicit authorization except as permitted by law.
Psychotherapy notes are maintained separately from the medical record and are not used or disclosed for treatment, payment, or healthcare operations without authorization, except as permitted by law.
Special Protections for Substance Use Disorder (Addiction) Records
Confidentiality of SUD Records (42 CFR Part 2): The confidentiality of substance use disorder (SUD) patient records maintained by Evolve Therapy & Counseling is protected by federal law and regulations.
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Stricter Disclosure Rules: Unlike general health information, we will not disclose any information identifying you as having a substance use disorder or as being a patient in our addiction program unless:
- You consent in writing;
- The disclosure is allowed by a court order; or
- The disclosure is made to medical personnel in a bona fide medical emergency.
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No Legal Use: Your SUD records, and any testimony relaying the content of those records, may not be used in any civil, criminal, administrative, or legislative proceedings against you by any federal, state, or local authority without your specific written consent or a qualifying court order.
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Reporting Crimes: Federal law does not protect information about a crime committed by a patient either at the program or against any person who works for the program or about any threat to commit such a crime.
Your Rights Regarding Your Health Information
You have the right to:
- Inspect and obtain a copy of your PHI (usually within 30 days of your written request)
- Request an amendment if you believe information is incorrect or incomplete
- Request restrictions on certain uses or disclosures
- Request confidential communications (for example, alternative contact methods)
- Receive an accounting of disclosures
- Receive a paper copy of this Notice, even if you agreed to receive it electronically
- Request restrictions on disclosures to your health plan for services you paid for in full out-of-pocket.
- We are required to agree to a request to restrict disclosure of protected health information to a health plan if the information relates solely to a service for which you have paid in full out of pocket.
Requests must be submitted in writing.
Personal Representatives
If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will confirm the person has this authority and can act for you before we take any action.
Our Responsibilities
We are required by law to maintain the privacy and security of your PHI and to notify you following a breach of unsecured PHI.
Changes to This Notice
We reserve the right to change this Notice at any time. Changes will apply to all PHI we maintain and will be posted on our website and available upon request.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with:
Evolve Therapy & CounselingPrivacy Officer: Liz Chelak, LCSW, CCTSI, CRPS
Miami, Florida
Phone: (786) 522-2376
Email: info@evolvetherapycounseling.com
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter or filing online:
200 Independence Avenue, S.W.Washington, D.C. 20201
Phone: (877) 696-6775
Website: www.hhs.gov/ocr/privacy/hipaa/complaints/
You have the right to file a complaint directly with the Secretary of Health and Human Services (HHS) and with our Privacy Officer if you believe your substance use disorder privacy rights have been violated. We will not retaliate against you for filing a complaint.
Contact Information
Evolve Therapy & CounselingServing Miami, Brickell, Boca Raton, West Palm Beach & surrounding areas
Phone: (786) 522-2376
Email: info@evolvetherapycounseling.com
Website: https://www.evolvetherapycounseling.com/