NOTICE OF PRIVACY PRACTICES
Bruckner Counseling, LLC
3651 Mars Hill Road, Suite 500B
Watkinsville, GA 30677
706-223-0908
Fax: 706-310-8113
admin@brucknercounseling.com
Effective Date: August 27, 2026
THIS NOTICE DESCRIBES HOW MEDICAL AND MENTAL HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This Notice applies to Bruckner Counseling, LLC and the clinicians, staff, contractors, and other workforce members who provide or support services through the practice.
Bruckner Counseling is committed to protecting the privacy and confidentiality of your health information. We create and maintain records of the care and services you receive from us. We use these records to provide treatment, operate the practice, obtain payment for services, and meet our legal and professional obligations.
Your Rights
When it comes to your health information, you have certain rights.
Get an electronic or paper copy of your record
You may ask to see or receive an electronic or paper copy of your medical record and other health information we maintain about you.
We will generally provide a copy or summary of your health information within 30 days of your request. We may charge a reasonable, cost-based fee when permitted by law.
Ask us to correct your record
You may ask us to correct health information you believe is incorrect or incomplete. We may deny your request in certain circumstances, but if we do, we will explain the reason in writing.
Request confidential communications
You may ask us to contact you in a particular way, such as only at a certain phone number, or to send communications to a different address. We will accommodate reasonable requests.
Ask us to limit what we use or share
You may ask us not to use or disclose certain health information for treatment, payment, or health care operations. We are generally not required to agree to your request.
If you pay for a service out of pocket in full, you may ask us not to disclose information about that service to your health insurer for payment or health care operations. We will honor that request unless disclosure is required by law.
Get a list of disclosures
You may request an accounting of certain disclosures of your health information made during the six years before your request. The accounting does not include certain disclosures, including many disclosures for treatment, payment, and health care operations or disclosures you specifically authorized. We will provide one accounting in a 12-month period at no charge. We may charge a reasonable, cost-based fee for additional requests during that period.
Get a copy of this Notice
You may request a paper copy of this Notice at any time, even if you previously agreed to receive it electronically.
Choose someone to act for you
If you have given someone medical power of attorney or another person has legal authority to act as your personal representative, that person may exercise your rights and make choices about your health information as permitted by law. We will verify that person's authority before taking action.
File a complaint
You may contact Bruckner Counseling if you believe your privacy rights have been violated. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights.
We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you may tell us your preferences about what we share.
You may tell us whether you want us to share relevant information with family members, close friends, or others involved in your care or payment for your care.
If you are unable to tell us your preference, such as during an emergency, we may share information when permitted by law if we believe doing so is in your best interest. We may also disclose information when necessary to prevent or reduce a serious and imminent threat to health or safety.
Marketing and Sale of Health Information
Bruckner Counseling does not sell your protected health information.
We do not use or disclose your protected health information for marketing purposes without your written authorization when authorization is required by law.
Substance Use Disorder Records
Some substance use disorder treatment records receive additional confidentiality protections under federal law, including 42 CFR Part 2.
If Bruckner Counseling creates or maintains records about you that are protected by 42 CFR Part 2, we will comply with the additional protections applicable to those records.
Part 2-protected records generally may not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you unless you provide specific written consent or the disclosure is authorized by an appropriate court order and subpoena or other legal authority as required by federal law.
If Part 2-protected information is used for fundraising purposes, you will be provided clear notice and an opportunity to opt out as required by law.
How We Typically Use and Share Your Health Information
Treatment
We may use your health information and share information with other health care professionals involved in your treatment when permitted by applicable law.
For example, a clinician may coordinate with another health care provider involved in your care.
Running our practice
We may use and share health information as necessary to operate Bruckner Counseling, improve the quality of care, supervise or consult regarding clinical services, manage our practice, and contact you when necessary.
Payment
We may use and disclose health information to bill and obtain payment from you, your health insurance plan, or another payer.
Other Uses and Disclosures
We may use or disclose health information without your written authorization when permitted or required by federal or state law.
Depending on the circumstances, these may include:
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Public health and safety activities
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Reporting suspected abuse or neglect as required by law
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Preventing or reducing a serious and imminent threat to health or safety
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Health oversight activities authorized by law
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Certain research activities permitted by law
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Workers' compensation matters
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Certain law enforcement or governmental requests
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Certain judicial or administrative proceedings
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Compliance with federal or state law
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Disclosures to coroners, medical examiners, or funeral directors as permitted by law
Mental health information is also protected by Georgia confidentiality laws and professional ethical requirements. Bruckner Counseling clinicians hold information obtained during the professional relationship in confidence and disclose such information only with appropriate authorization or when disclosure is permitted or required by applicable law.
Additional restrictions may apply to privileged mental health communications and records protected by 42 CFR Part 2. We will comply with those additional protections when applicable.
Our Responsibilities
We are required by law to maintain the privacy and security of your protected health information.
We will notify you as required by law if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in the Notice currently in effect.
We will not use or disclose your information other than as described in this Notice unless you authorize us to do so in writing or another use or disclosure is permitted or required by law.
If you provide written authorization, you may revoke it in writing at any time, except to the extent we have already acted in reliance on it.
We may change the terms of this Notice. Changes may apply to all health information we maintain about you, including information created or received before the change. The current Notice will be available upon request, at our office, and on our website.
Privacy Questions or Complaints
For questions about this Notice, requests concerning your privacy rights, or complaints about Bruckner Counseling's privacy practices, contact:
Bruckner Counseling, LLC
3651 Mars Hill Road, Suite 500B
Watkinsville, GA 30677
706-223-0908
admin@brucknercounseling.com
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. Bruckner Counseling will not retaliate against you for filing a complaint.