Notice of Privacy Practices
This notice describes how health information about you may be used and disclosed, and how you can get access to this information. Please review it carefully. Effective September 2026.
Our commitment. Northlight Counseling, PLLC is required by law to protect the privacy of your protected health information (PHI), to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect.
How we may use and disclose your information without your written authorization
Treatment. To provide, coordinate or manage your care, for example consulting with another provider you have asked us to coordinate with.
Payment. To bill and collect payment for services, including verifying coverage with your insurer and submitting claims. Insurers typically require a diagnosis and dates of service.
Health care operations. For quality review, clinical supervision and consultation, and administration of the practice. Supervisors and consultants are also bound to protect your information.
Required by law. Where federal, state or local law requires disclosure.
Safety. If we believe disclosure is necessary to prevent a serious and imminent threat to your health or safety or that of another person.
Abuse or neglect. Utah and Washington law require us to report suspected abuse or neglect of a child, a vulnerable adult or an elder.
Court orders. In response to a court order, subpoena or other lawful process, to the extent the law requires.
Uses that always require your written authorization
Most uses and disclosures of psychotherapy notes, any use for marketing purposes, and any sale of your information require your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted on it.
Your rights
Access. You may inspect and request a copy of your record. We may charge a reasonable fee for copying.
Amendment. You may ask us to correct information you believe is incorrect or incomplete. We may deny the request in writing and you may file a statement of disagreement.
Accounting of disclosures. You may request a list of certain disclosures we have made.
Restrictions. You may ask us to limit how we use or disclose your information. We are not required to agree, except that if you pay in full out of pocket for a service, you may direct that we not share it with your insurer.
Confidential communications. You may ask us to contact you in a specific way or at a specific place.
Paper copy. You may request a paper copy of this notice at any time.
Breach notification. You will be notified if a breach compromises the privacy or security of your information.
Questions and complaints
If you have questions about this notice, or you believe your privacy rights have been violated, contact Calie Adams, LCSW at 385-582-9559 or info@northlightcounselingutah.com. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, at www.hhs.gov/hipaa/filing-a-complaint online. You will not be retaliated against for filing a complaint.
Changes to this notice. We may change this notice and make the new terms effective for all information we maintain. The current version will always be posted here.
Northlight Counseling, PLLC · 746 E 1910 S, Suite 4, Provo, UT 84606 · 385-582-9559