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Notice of Privacy and Confidentiality Practices

Scott McDougal, LPC-MHSP. Effective Date: September 23, 2026.

THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOUR MENTAL HEALTH CARE MAY BE USED AND DISCLOSED, HOW YOU MAY OBTAIN ACCESS TO YOUR RECORDS, AND YOUR RIGHTS REGARDING YOUR CONFIDENTIAL INFORMATION. PLEASE REVIEW IT CAREFULLY.

I. MY COMMITMENT REGARDING YOUR INFORMATION

Information about your mental health, treatment, and personal circumstances is private and confidential. I am committed to protecting that information and maintaining records in accordance with applicable Tennessee and federal law and professional ethical requirements.

I maintain records of the care and services I provide. These records are used to provide treatment, document services, coordinate care when appropriate, operate my practice, and satisfy applicable legal and professional requirements.

As a Tennessee Licensed Professional Counselor with Mental Health Service Provider designation (LPC-MHSP), I am subject to Tennessee confidentiality laws governing communications between licensed professional counselors and their clients.

I will:

  • Take reasonable steps to protect the privacy and security of your confidential health and treatment information.
  • Use or disclose your information only as permitted by applicable law, as described in this Notice, or as authorized by you.
  • Follow applicable Tennessee confidentiality and professional-practice requirements.
  • Notify you of an unauthorized disclosure or security breach when notification is required by applicable law.
  • Provide you with information concerning your rights regarding your records.
  • Maintain appropriate safeguards for confidential information in paper and electronic form.

I may revise this Notice if my practices or applicable laws change. The current version will be available upon request and on my practice website.

II. CONFIDENTIALITY OF COUNSELING COMMUNICATIONS

Tennessee law provides significant confidentiality protection for communications between licensed professional counselors and their clients.

Confidential relations and communications between a licensed professional counselor and a client are generally protected on the same basis as confidential communications between an attorney and client, subject to exceptions established by law.

I will not disclose confidential counseling information merely because another person or organization requests it.

If I receive a subpoena, records request, legal demand, or other request for confidential information, I will consider the confidentiality, privilege, authorization, court-order, and other legal requirements that apply before releasing information.

There are circumstances in which disclosure may be permitted or required by law. These may include mandatory reporting requirements, certain threats to health or safety, legally sufficient court orders, or other situations specifically authorized by law.

III. HOW YOUR INFORMATION MAY BE USED

1. Treatment

I use information about you to provide mental health assessment, counseling, psychotherapy, treatment planning, and related professional services.

When appropriate and legally permitted, information may also be used to coordinate your treatment with another health care professional.

For example, with your authorization or when otherwise permitted by law, I may communicate with your physician, psychiatrist, or another treating professional regarding information relevant to coordinating your care.

2. Professional Consultation

Mental health professionals may obtain professional consultation concerning clinical issues.

When consultation is appropriate, I will make reasonable efforts to protect your identity and disclose only information reasonably necessary for the consultation.

If identifiable confidential information is disclosed, the recipient must be legally or professionally authorized to receive that information.

3. Practice Operations

Information may be used as reasonably necessary to operate my practice, including scheduling, recordkeeping, administrative activities, professional compliance, quality assurance, technology services, payment processing, and other activities related to providing mental health services.

Outside service providers that receive confidential client information will be selected and used with appropriate attention to privacy, confidentiality, contractual, technological, and professional requirements.

4. Payment

My practice is currently self-pay and does not submit claims to health insurance plans.

Information necessary to process your payment, provide receipts, maintain financial records, or document services may be used for those purposes.

If you request documentation so that you may independently seek reimbursement from a health plan, flexible-spending account, health-savings account, or another third party, I may provide appropriate documentation at your request when permitted by law.

5. Appointment and Treatment Communications

I may use the contact information you provide to communicate with you regarding:

  • Appointments and scheduling;
  • Cancellations or changes;
  • Treatment-related matters;
  • Requested resources or referrals;
  • Billing or payment matters; and
  • Other matters reasonably related to your care.

You may speak with me about reasonable preferences concerning how you would like to be contacted.

IV. DISCLOSURES THAT MAY BE PERMITTED OR REQUIRED WITHOUT YOUR AUTHORIZATION

Your information may be disclosed without your written authorization when applicable law permits or requires the disclosure.

These situations may include:

1. Child Abuse or Neglect

I must comply with Tennessee mandatory-reporting laws concerning suspected child abuse or neglect.

Information disclosed will be limited as appropriate to complying with the applicable reporting requirements.

2. Abuse, Neglect, or Exploitation of Vulnerable Persons

Information may be disclosed when reporting is required or permitted under applicable Tennessee law concerning abuse, neglect, or exploitation of an adult or other vulnerable person.

3. Serious Threats to Health or Safety

Information may be disclosed when permitted or required by law to prevent or reduce a serious threat to your health or safety or the health or safety of another person.

Any disclosure will be limited to what is reasonably necessary and legally permitted under the circumstances.

4. Court and Legal Proceedings

Information may be disclosed pursuant to a legally sufficient court order or other legal requirement.

A subpoena, attorney request, discovery request, or other request for records does not necessarily eliminate the confidentiality or privilege protections that apply to counseling communications. I will evaluate the legal authority for the request and any applicable privilege or confidentiality protection before releasing confidential information.

5. Health Oversight and Licensing Activities

Information may be disclosed when required by a legally authorized investigation, licensing proceeding, professional disciplinary proceeding, or other health-oversight activity.

6. Law Enforcement

Information may be disclosed to law enforcement when disclosure is specifically permitted or required by applicable law.

7. Coroners or Medical Examiners

Information may be disclosed to a coroner or medical examiner when authorized or required by law.

8. Other Requirements of Law

Information may be used or disclosed when another applicable federal or Tennessee law specifically requires or permits the disclosure.

V. DISCLOSURES TO FAMILY MEMBERS, FRIENDS, AND OTHERS

I will not ordinarily disclose information about your counseling to family members, friends, employers, schools, attorneys, or other individuals merely because they request information.

You may authorize me to communicate with a person involved in your care or otherwise designated by you.

You may limit or revoke that authorization as permitted by law.

If you are unable to communicate your wishes during an emergency or because of incapacity, limited information may be disclosed when legally permitted and when, using professional judgment, I determine that doing so is appropriate and in your best interest.

VI. WRITTEN AUTHORIZATION

Except when disclosure is otherwise permitted or required by law, I will obtain your written authorization before releasing confidential information to another person or organization.

An authorization will ordinarily identify:

  • The information that may be disclosed;
  • The person or organization authorized to disclose the information;
  • The person or organization permitted to receive the information;
  • The purpose of the disclosure, when applicable;
  • An expiration date or event; and
  • Any other information required by applicable law.

You may revoke an authorization in writing at any time, except to the extent that I have already acted in reliance upon the authorization or applicable law provides otherwise.

VII. CLINICAL AND PSYCHOTHERAPY NOTES

I maintain clinical documentation concerning the mental health services I provide.

Clinical records may include information such as presenting concerns, diagnoses when applicable, treatment plans, session dates, interventions, progress, symptoms, risk assessments, referrals, and other information relevant to treatment.

I may also maintain separate psychotherapy, process, or personal clinical notes used to assist me in understanding or analyzing therapy sessions.

Records and notes are maintained, accessed, and disclosed according to applicable Tennessee and federal law and professional requirements.

Nothing in this Notice is intended to limit any right you have under Tennessee law to obtain your medical or clinical record.

VIII. SUBSTANCE USE DISORDER INFORMATION

I am not a substance use disorder treatment program and do not hold my practice out as a program specializing in substance use disorder diagnosis, treatment, or referral.

However, if I receive records from another provider or program that are subject to special federal confidentiality protections under 42 CFR Part 2, I will handle those records in accordance with the legal restrictions applicable to those records and to me as a recipient.

Information protected by 42 CFR Part 2 may be subject to additional restrictions concerning its use in civil, criminal, administrative, or legislative investigations or proceedings against the individual who is the subject of the records.

IX. RESEARCH, MARKETING, FUNDRAISING, AND SALE OF CLIENT INFORMATION

I do not currently conduct research using identifiable client treatment information.

I do not use client treatment information for fundraising.

I do not sell client health or treatment information.

I will not use confidential treatment information for third-party marketing in a manner prohibited by applicable law or professional ethical requirements.

X. YOUR RIGHTS REGARDING YOUR RECORDS

1. Right to Request Your Records

You or your legally authorized representative may submit a written request for a copy of your client records.

In accordance with Tennessee law, I will provide the requested medical or clinical records within ten (10) working days after receiving a written request, subject to applicable law.

A summary of your records may be provided when appropriate, but a summary will not substitute for your right to receive the full record when applicable Tennessee law entitles you to the full record.

Reasonable fees permitted by applicable law may be charged for copying, supplies, postage, or related costs.

2. Right to Request Correction or Clarification

If you believe information maintained in your record is inaccurate or incomplete, you may notify me and request that the information be corrected or supplemented.

I will consider your request in accordance with applicable law and professional recordkeeping requirements.

A clinical record will not ordinarily be altered by deleting historically accurate documentation. When appropriate, a correction, clarification, or supplemental entry may be added.

3. Right to Request Confidential Communications

You may ask me to communicate with you in a particular manner or through a particular contact method.

I will accommodate reasonable requests when practicable.

4. Right to Authorize Disclosure

You may authorize disclosure of confidential information to another person or organization.

You may revoke that authorization as described in this Notice.

5. Right to a Copy of This Notice

You may request a paper or electronic copy of this Notice at any time.

6. Personal Representatives

A legally authorized personal representative may exercise rights concerning your records when that person's authority is recognized under applicable law.

I may require appropriate documentation establishing that authority before providing access to confidential information.

XI. SECURITY AND ELECTRONIC COMMUNICATIONS

I take reasonable administrative, physical, and technological measures to protect confidential client information.

These measures may include appropriate access controls, passwords, secure recordkeeping systems, device safeguards, secure storage, and other measures appropriate to the nature of the information maintained.

Electronic communication, including email, text messaging, client portals, telehealth systems, and other electronic services, may involve privacy and security risks.

I will use reasonable safeguards appropriate to the information and method of communication.

You are encouraged to discuss with me any concerns you have about electronic communication or the method by which I contact you.

XII. PRIVACY OR CONFIDENTIALITY CONCERNS

If you believe your confidential information has been handled improperly, have questions about this Notice, or would like to discuss your privacy rights, please contact:

Scott McDougal, LPC-MHSP, Privacy Officer
Phone: 615-497-0219
Email: info@clearlyawaretherapy.com
Website: www.clearlyawaretherapy.com

You may also contact the appropriate Tennessee licensing or regulatory authority regarding concerns involving professional confidentiality or professional conduct.

I will not retaliate against you for raising a privacy or confidentiality concern, requesting access to your records, or exercising a right provided to you under applicable law.

XIII. FUTURE APPLICATION OF HIPAA OR OTHER PRIVACY REQUIREMENTS

My practice is currently self-pay and does not electronically submit health insurance claims or conduct other standardized health-plan transactions that would make the practice a HIPAA-covered health care provider based on its current operations.

If my practice begins conducting electronic transactions that cause it to become a covered entity under the Health Insurance Portability and Accountability Act (“HIPAA”), or otherwise becomes subject to additional federal privacy requirements, I will revise my privacy practices and this Notice as required by applicable law.

Becoming subject to HIPAA or another privacy law may create additional rights, procedures, safeguards, documentation requirements, or restrictions beyond those described in this Notice.

A revised Notice will be made available to clients when required.

Regardless of whether HIPAA currently applies to my practice, I remain obligated to protect client confidentiality under applicable Tennessee law, professional licensing requirements, ethical obligations, and other applicable law.

XIV. CHANGES TO THESE PRIVACY PRACTICES

I may change these privacy and confidentiality practices when changes in my practice, technology, professional requirements, or applicable law make revisions appropriate.

Changes may apply to information already maintained by me as well as information received after the change, to the extent permitted by applicable law.

If a material change affects your rights or my responsibilities, I will revise this Notice as appropriate.

The current Notice will be available upon request and through my practice website.

XV. CONTACT INFORMATION

Scott McDougal, LPC-MHSP, Privacy Officer

Phone: 615-497-0219

Email: info@clearlyawaretherapy.com

Website: www.clearlyawaretherapy.com

Effective Date: September 23, 2026