Footsteps Counseling Center Privacy Policy


This Notice describes how medical information about you may be used and disclosed, and how you can get access to this information. Please review it carefully.

Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. Typically this record contains your symptoms, diagnoses, treatment, a plan for future care or treatment, session notes, and billing-related information. This notice applies to all of the records of your care at Footsteps.

Our Responsibilities

We are required by law to maintain the privacy of your health information and provide you a description of our privacy practices. We will abide by the terms of this notice.

Uses and Disclosures

How we may use and disclose health information about you. The following categories describe examples of the way we use and disclose health information:

For Treatment: We may use health information about you to provide you treatment or services. We may disclose health information about you to other healthcare providers who are involved in taking care of you, including you primary care physician.

For Payment: We may use and disclose health information about your treatment and services to bill and collect payment from you, your insurance company or third party payer.

For Healthcare Operations: Members of the Footsteps staff may use information in your health record to assess the care and outcomes in your case and others like it. The results will then be used to continually improve the quality of care for all patients we serve. For example, we may combine the health information about many patients to evaluate the need for new services or treatment. We may disclose information to others staff for educational purposes. We may remove information that identifies you from this set of health information to protect your privacy.

We may also use and disclose health information:

- To business associates we have contracted with to perform the agreed upon service and billing for it;

- To remind you that you have an appointment;

- To assess your satisfaction with our services;

- To tell you about possible treatment alternatives;

- To contact you as part of fundraising efforts;

- For population –based activities relating to improving health or reducing healthcare costs; and

- For conducting training programs or reviewing competence of healthcare professionals.

When disclosing information, primarily appointment reminders and billing/collections efforts, we may leave messages on you answering machine/voice mail.

Business Associates: There are some services provided in our organization through contract with business associates. Examples include payroll services, HR services, maintenance, etc. When these services are contracted, we may disclose your health information to our business associates so that they can perform the job we’ve asked them to do and bill you or your third-part payer for services rendered. To protect you health information, however, we require the business associate to appropriately safeguard your information.

Future Communications: We may communicate to you via newsletters, mail outs, or other means regarding treatment options, health-related information, or other community-based initiatives or activities that our facility is participating in.

Organized Healthcare Arrangement: This facility and is staff members have organized and are presenting you this document as a joint notice. Information will be shared, as necessary, to carry out treatment, payment and health care operations. Counselors may have access to protected health information to assist in reviewing past treatment as it may affect treatment at the time.

As required by law, we may also use and disclose health information for the following types of entities, including, but not limited to:

- As required by law (ex. Court-ordered warrant, Virginia Health information)

- Public health activities (communicable diseases)

- Judicial and Administrative proceedings

- Law Enforcement purposes

- To avert a serious threat to health and Safety of others (ex: in response to a statement made by a person served to harm self or another)

- Children or incapacitated adults who are victims of abuse, neglect, or exploitation

- Government functions

- Military Services

- Coroners and Medical Examiners for identification of a deceased person or to determine cause of death.

Your Health Information Rights

Although your health record is the physical property of the healthcare practitioner or facility that compiled it, you have the Right to:

- Inspect and Copy: You have the right to inspect and obtain a copy of the health information that may be used to make decisions about your care. Usually, this includes medical and billing record, but does not include psychotherapy notes. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to health information, you may request that the denial be reviewed. Another licensed healthcare professional chosen by the hospital will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

- Amend: If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request and amendment for as long as the information is kept by or for this agency. We may deny your request for an amendment; and, if this occurs, you will be notified of the reason for the denial.

- An Accounting of Disclosures: You have the right to request an accounting of disclosers. This is a list of certain disclosures we make of your health information for purposes other than treatment, payment, or healthcare operations where an authorization was not required.

- Request Restrictions: You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment or healthcare operations. You also have the right to request a limit on the health information we disclosed about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.

- Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you may ask that we contact you at work instead of your home. The facility will grant reasonable requests for confidential communications at alternative locations and/or via alternative mans only the request includes a mailing address where the individual will receive bills for services rendered by the facility and related correspondence regarding payment for services. Pease realize, we reserve the right to contact you by other means and at other locations if you fail to respond to any communication from us that requires a response. We will notify you in accordance with your original request prior to attempting to contact you by other means or at another location.

- A Paper Copy of This Notice: You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. To exercise any of your rights, please obtain the required forms from the Facility Privacy Official and submit your request in writing.


We reserve the right to changes this notice and the revised or changed notice will be effective for information we already have about you as well as any information we receive in the future. The current notice will be posted in the hospital and include the effective date. In addition, each time you register at or are admitted for services, the copy of the current notice is available to you.


If you believe your privacy rights have been violated, you may file a complaint with the facility by following the process outlined in the Patient’s Rights documentation. You may also file a complaint with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing.

You will not be penalized for filing a complaint.


Other uses and disclosures of health information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose health information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer us or disclose health information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that w are required to retain our records of the care that we provided to you.