The Life Empowerment Center (TLEC) is committed to protecting the privacy of your health information. We are required by law to maintain the privacy of your protected health information (PHI), provide you with this notice of our legal duties and privacy practices, and notify you in the event of a breach of your unsecured PHI.

For treatment

We may use and share your health information to provide, coordinate, or manage your care. For example, we may share relevant information with another healthcare provider involved in your treatment, such as a psychiatrist or your primary care physician, if we determine it is necessary for your care.

For payment

We may use and disclose your health information to bill and receive payment for services. For example, we may submit a claim to your insurance company that includes information about the services you received.

For healthcare operations

We may use your information for internal practice operations such as quality improvement, staff training, and business management. This information is never sold or used for marketing purposes.

As required by law

We may disclose your health information when required to do so by federal, state, or local law.

Mandatory reporting

There are specific situations where we are required by law to disclose information without your consent:

• Risk of harm to self or others — If you disclose information suggesting you are at imminent risk of harming yourself or another person, we are required to take steps to prevent that harm, which may include contacting emergency services or a third party.

• Abuse or neglect — We are required to report suspected abuse or neglect of a child, elderly person, or dependent adult to the appropriate authorities.

• Court orders — We may be required to disclose records in response to a valid court order or subpoena.

Permissive disclosures (without authorization)

In certain circumstances, we may disclose information without your written authorization, including to:

• Public health authorities for disease reporting

• Law enforcement under specific legal circumstances

• Coroners or medical examiners as required

• Correctional institutions if you are an inmate

You have the following rights with respect to your protected health information:

Right to access — You may request a copy of your health records. We will provide access within 30 days of your request. A reasonable fee may apply for copies.

Right to amend — You may request that we correct or amend information in your records if you believe it is inaccurate or incomplete.

Right to an accounting of disclosures — You may request a list of instances where we have disclosed your health information for purposes other than treatment, payment, or operations.

Right to restrict disclosures — You may request that we restrict how we use or disclose your information. We are not required to agree to all requests, but we will consider each one carefully.

Right to confidential communications — You may request that we communicate with you in a specific way or at a specific location (for example, only by email or only at a certain phone number).

Right to a paper copy of this notice — You may request a paper copy of this notice at any time, even if you have agreed to receive it electronically.

Right to revoke authorization — If you have signed an authorization to release your information, you may revoke it at any time in writing, except where we have already acted on it.

We maintain physical, electronic, and procedural safeguards to protect your health information. These include:

• Encrypted electronic health records

• Secure, password-protected systems

• Limited staff access on a need-to-know basis

• Secure disposal of paper records

If you participate in telehealth sessions, your sessions are conducted through a HIPAA-compliant platform. We do not conduct sessions over standard video or phone platforms that are not HIPAA-compliant.

Email and text communication between sessions is for scheduling and administrative purposes only. Please do not share sensitive clinical information via email or text, as these channels may not be fully secure.

We reserve the right to change this notice and to make the revised notice effective for health information we already have about you, as well as information we receive in the future. We will post the current notice on our website and make a copy available upon request.

In addition to federal HIPAA requirements, this practice complies with the Texas Health & Safety Code Chapter 611, which provides additional protections for mental health records in Texas. Key points include:

• Mental health records may not be disclosed without your written authorization except in specific circumstances defined by Texas law

• Texas law imposes stricter limitations on certain disclosures than federal HIPAA minimums

• You have the right to request your mental health records directly from this practice

• Records may not be disclosed to employers, family members, or others without your written consent except as required or permitted by law

Texas mandatory reporting obligations also include reporting to the Texas Department of Family and Protective Services (DFPS) when there is reasonable cause to believe a child has been abused or neglected, and reporting elder or disabled adult abuse to Adult Protective Services (APS).

This practice is licensed by the Texas State Board of Examiners of Professional Counselors (TSBEP) [or applicable board — LPC, LCSW, LMFT, etc.]. Complaints regarding your care or privacy rights may also be directed to:

Texas State Board of Examiners of Professional Counselors 1100 W. 49th Street, Austin, TX 78756 (512) 834-6658 | www.dshs.texas.gov/counselor

If you believe your privacy rights have been violated, you may file a complaint with our practice or with the U.S. Department of Health and Human Services Office for Civil Rights.

To file with our practice: James Ochoa, Inc dba The Life Empowerment Center (TLEC) — Privacy Officer | 1111 Virtual Zoom Dr, Austin, TX 78704 | 512-804-2343 | admin@tlec.info

To file with the federal government: U.S. Department of Health and Human Services 200 Independence Avenue S.W. Washington, D.C. 20201 www.hhs.gov/ocr/privacy/hipaa/complaints

You will not be retaliated against for filing a complaint.