Notice of Privacy Practices

Turquoise Owl Therapy PLLC

Effective date: 10/23/2026

THIS NOTICE DESCRIBES HOW YOUR MENTAL HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Turquoise Owl Therapy PLLC is committed to protecting the privacy of your mental health information. This Notice of Privacy Practices describes how we may use and disclose your protected health information (PHI), your rights regarding that information, and our legal responsibilities.

This notice applies to the therapy services provided by Turquoise Owl Therapy PLLC. It reflects applicable federal privacy requirements and Illinois confidentiality laws. Some information may be subject to additional protections under state or federal law.

1. Your Rights

When it comes to your health information, you have certain rights. You may exercise these rights by contacting us using the information at the end of this notice.

Obtain a Copy of Your Records

You may request to inspect or obtain a paper or electronic copy of your health records maintained by us, subject to applicable law and any permitted exceptions.

We will generally respond to a request for access within 30 days. If an extension is permitted and needed, we will notify you in writing of the reason and the expected completion date.

We may charge a reasonable, cost-based fee where permitted by law.

Certain separately maintained psychotherapy notes and other records subject to specific legal protections may not be accessible under the ordinary HIPAA right of access.

Request a Correction

You may ask us to amend health information that you believe is incorrect or incomplete.

We may deny your request in certain circumstances permitted by law. If we deny it, we will provide a written explanation and information about your options.

Request Confidential Communications

You may ask us to contact you in a particular way or at a specific location. For example, you may ask us to contact you by email rather than telephone, or to use a different telephone number.

We will accommodate reasonable requests as required by law. Please tell us how you would prefer to be contacted and whether a particular method could put your safety or privacy at risk.

Request Restrictions on Uses and Disclosures

You may ask us to limit how we use or disclose your health information for treatment, payment, or healthcare operations.

We are not required to agree to every request, except where applicable law requires us to do so.

If you pay for a service entirely out of pocket and request that we not disclose information about that service to your health plan for payment or healthcare operations, we generally must honor that request unless disclosure is otherwise required by law.

Request an Accounting of Disclosures

You may request a list of certain disclosures of your health information made by us during the six years preceding your request, subject to applicable exceptions.

The accounting does not include every disclosure. For example, disclosures for treatment, payment, and healthcare operations are generally excluded, as are certain disclosures you authorized or that are otherwise exempt under law.

We will provide one accounting within a 12-month period without charge. We may charge a reasonable, cost-based fee for additional requests during that period, as permitted by law.

Obtain 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 a person has legal authority to act on your behalf, such as a legally authorized representative or guardian, that person may exercise your rights as permitted by law.

We will verify the person's authority before acting on a request.

File a Complaint

You may file a complaint if you believe your privacy rights have been violated. You may contact us or 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.

2. Your Choices About Certain Uses and Disclosures

For certain disclosures of your health information, you may tell us your preferences.

People Involved in Your Care

You may tell us whether you want us to share relevant information with a family member, friend, or another person involved in your care or payment for your care, to the extent permitted by law.

If you are unable to express your preference, we may disclose limited information when permitted by law and when we determine that doing so is in your best interests or is necessary to address a serious and imminent threat to health or safety.

Illinois confidentiality law may impose additional restrictions on disclosures of mental health information.

Other Uses Requiring Your Written Authorization

We generally need your written authorization for uses and disclosures of your health information that are not described in this notice or otherwise permitted or required by law.

In particular, written authorization is generally required for:

• Marketing uses and disclosures that require authorization under HIPAA.

• The sale of protected health information.

• Most uses and disclosures of separately maintained psychotherapy notes, subject to legal exceptions.

You may revoke an authorization in writing at any time. Revocation will not affect actions already taken in reliance on the authorization, to the extent permitted by law.

We do not use or disclose your health information for marketing purposes or sell your protected health information as part of our current practice.

3. How We May Use and Disclose Your Health Information

We may use and disclose your health information for the purposes described below, as permitted or required by applicable law.

Treatment

We may use your information to provide, coordinate, or manage your mental health care.

For example, we may review your treatment history, document your progress, or communicate with another healthcare professional involved in your care when legally permitted.

We will follow applicable confidentiality requirements when sharing mental health information with other providers.

Payment

We may use and disclose relevant information to obtain payment for services.

For example, if you use insurance, we may provide information necessary to verify benefits, obtain authorization for services, submit claims, or receive payment from your health plan.

The information shared will depend on the requirements of the payment arrangement and applicable law.

Healthcare Operations

We may use and disclose information for activities necessary to operate and manage our practice, as permitted by law.

These activities may include administrative functions, quality assessment, compliance activities, and other permitted practice-management tasks.

Practice Administration and Service Providers

We use third-party platforms and service providers to support scheduling, communications, billing, documentation, and other practice functions.

Depending on the services involved, these may include Alma, Headway, iPlum, Hushmail, Therapy Notes and other authorized providers.

Information may be shared with a provider when necessary for that provider to perform services on our behalf or to facilitate care, payment, or practice operations, as permitted by law and applicable agreements.

Some platforms may independently administer their own services, including insurance, referral, or payment functions, and may have separate privacy practices. The information they handle may be subject to their own legal obligations and agreements.

We take reasonable steps to use appropriate safeguards and agreements when required. We do not control every aspect of the privacy practices of independent third-party platforms.

Appointment and Care Communications

We may contact you about appointments, scheduling changes, treatment-related matters, billing, or other practice-related issues.

Depending on your preferences and the communication method you have selected, these communications may occur by telephone, voicemail, text message, email, or through a secure or authorized client portal.

We use iPlum for telephone-related communications and Hushmail for email communications. You may discuss your communication preferences with us, including requests for confidential communications.

Electronic communication carries some privacy risks. Please let us know if you have concerns about receiving messages through a particular method.

4. Other Permitted or Required Disclosures

We may disclose health information without your written authorization in certain circumstances permitted or required by law, including the following.

Public Health and Safety

We may disclose information for certain public health activities, to report suspected abuse or neglect where reporting is legally required or permitted, or to prevent or lessen a serious and imminent threat to health or safety, as allowed by law.

Legal Requirements and Oversight

We may disclose information when required by federal or state law, or to authorized government agencies conducting legally permitted oversight or compliance activities.

Law Enforcement and Government Requests

We may disclose information to law enforcement or government officials when the applicable legal requirements are satisfied. We will consider any additional protections applicable to mental health records and will not treat every request, subpoena, or investigation as automatically authorizing disclosure.

Court Proceedings and Legal Disputes

We may disclose information in response to a court or administrative order, or other legal process, when disclosure is permitted or required by applicable law.

Additional restrictions may apply to mental health records and substance use disorder records.

Abuse, Neglect, or Domestic Violence

We may disclose information to appropriate authorities when reporting or disclosure is required or permitted by law, including in certain cases involving suspected abuse, neglect, or domestic violence.

Workers' Compensation

We may disclose information as authorized by laws governing workers' compensation and related programs.

Other Legally Permitted Purposes

Other disclosures may be permitted or required by law, including certain disclosures involving health oversight, public health, serious threats to safety, and legal proceedings. Any such disclosure will be subject to the applicable legal requirements and confidentiality protections.

5. Illinois Mental Health Confidentiality Protections

Illinois law provides specific protections for mental health and developmental disabilities records and communications, including under the Illinois Mental Health and Developmental Disabilities Confidentiality Act.

These protections may be more restrictive than the general federal HIPAA rules in certain circumstances.

We will handle mental health records and communications in accordance with applicable Illinois law, including its requirements concerning consent, confidentiality, and legally permitted exceptions.

We will not assume that information may be disclosed simply because a disclosure might be permitted under a general HIPAA provision. Where a more protective law applies, we will follow the applicable legal requirements.

Questions about a particular disclosure or request may be directed to us using the contact information at the end of this notice.

6. Special Protections for Substance Use Disorder Records

Certain substance use disorder patient records may be subject to additional federal confidentiality protections under 42 U.S.C. § 290dd-2 and 42 CFR Part 2.

To the extent that we receive or maintain records subject to these protections, we will comply with the applicable requirements.

We will not use or disclose records protected by 42 CFR Part 2 in civil, criminal, administrative, or legislative investigations or proceedings against the patient without the consent or court order and subpoena required by applicable federal law.

Additional consent requirements and restrictions may apply to the use and disclosure of these records. These protections do not automatically apply to every record mentioning substance use; their applicability depends on the nature of the records and the program or provider involved.

7. Psychotherapy Notes

Psychotherapy notes are notes maintained separately by a mental health professional that document or analyze the contents of a counseling session and meet the definition under HIPAA.

They are distinct from the ordinary clinical record, which may include diagnoses, symptoms, treatment plans, progress summaries, medication information, and other information needed to provide care.

When applicable, psychotherapy notes receive special protection under HIPAA. Most uses and disclosures of separately maintained psychotherapy notes require your written authorization, subject to specific legal exceptions.

Not every note written during therapy qualifies as a psychotherapy note under HIPAA. Access to and disclosure of clinical records are governed by the applicable laws and the nature of the records involved.

8. Our Responsibilities

We are required by law to:

• Maintain the privacy and security of protected health information.

• Provide you with notice of our legal duties and privacy practices.

• Follow the terms of the Notice of Privacy Practices currently in effect.

• Notify affected individuals when a breach of unsecured protected health information requires notification under applicable law.

• Use and disclose your information only as permitted or required by law, this notice, or a valid authorization.

We use reasonable administrative, technical, and physical safeguards to protect information. No electronic system or communication method can be guaranteed to be completely secure.

We may update this notice as our practices or legal obligations change. Changes will apply to information we maintain as permitted by law. The current notice will be available upon request and on our website.

If a material change affects our privacy practices, we will revise this notice and provide it as required by applicable law.

9. How to Exercise Your Rights or File a Complaint

To request records, request an amendment or restriction, ask for confidential communications, obtain a copy of this notice, or raise a privacy concern, please contact:

Turquoise Owl Therapy PLLC
Email: robin@turquoiseowltherapy.com
Telephone: 630-474-8098

You may also submit a complaint to the U.S. Department of Health and Human Services Office for Civil Rights:

Office for Civil Rights, U.S. Department of Health and Human Services
Website: https://www.hhs.gov/hipaa/filing-a-complaint/index.html
Telephone: 1-800-368-1019

You will not be penalized or retaliated against for filing a complaint.

10. Acknowledgment of Receipt

We will provide this Notice of Privacy Practices as required by law and make a good-faith effort to obtain acknowledgment of receipt when required.

Acknowledging receipt does not mean that you have authorized any particular use or disclosure of your health information.

Turquoise Owl Therapy PLLC
Website: https://turquoiseowltherapy.com
Email: robin@turquoiseowltherapy.com