Notice of Privacy Practices
Brickel and Associates, LLC
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.
Brickel and Associates, LLC (the “Practice”) is committed to protecting your privacy. We are required by law to maintain the privacy and security of your Protected Health Information (“PHI”), which includes information that identifies you or could reasonably be used to identify you. We are also required to provide you with this Notice of Privacy Practices (“Notice”), which explains our legal duties, privacy practices, and your rights regarding the PHI we create or maintain.
YOUR RIGHTS
You have the following rights regarding your PHI. To exercise these rights, you must submit a written request to the Practice using the contact information listed below.
Right to Inspect and Copy PHI
You may request to inspect or receive a paper or electronic copy of your PHI. We may charge a reasonable, cost-based fee for copies, mailing, or electronic media. We may deny access in limited circumstances, such as when access could reasonably be expected to endanger your life or physical safety or that of another person. You may request a review of a denial.
Right to Request an Amendment
You may request correction of PHI you believe is inaccurate or incomplete. Requests must be made in writing and include a reason. We may deny the request and will provide a written explanation. You may submit a written statement of disagreement.
Right to Request 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 at a particular phone number). We will accommodate all reasonable requests.
Right to Request Restrictions
You may request restrictions on certain uses or disclosures of PHI for treatment, payment, or health care operations. We are not required to agree to all requests if they would interfere with care or legal obligations.
If you pay for a service in full out-of-pocket, you may request that we not disclose information about that service to a health plan, and we must honor that request unless disclosure is required by law.
You may also request restrictions on disclosures to specific family members or others involved in your care.
Right to an Accounting of Disclosures
You may request a list of certain disclosures of your PHI made by the Practice. You are entitled to one free accounting every 12 months. Reasonable fees may apply for additional requests.
Right to Receive a Copy of This Notice
You may request a paper copy of this Notice at any time, even if you agreed to receive it electronically.
Right to Choose a Personal Representative
If you have granted someone medical power of attorney or if someone is your legal guardian, that person may exercise your rights upon proof of authority.
Right to File a Complaint
If you believe your privacy rights have been violated, you may file a complaint with:
Robyn Brickel, MA, LMFT
Clinical Director / Owner
Brickel and Associates, LLC
300 North Washington Street, Suite 500
Alexandria, VA 22314
703-518-8883
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.
OUR USES AND DISCLOSURES OF PHI
Uses and Disclosures for Treatment, Payment, and Health Care Operations
We may use and disclose PHI without your written authorization for:
- Treatment – coordinating care with other providers at your request
- Payment – collecting payment from you or entities you direct
- Health Care Operations – administrative, legal, quality assurance, and business functions
We may communicate with you electronically (such as by email or text) with your consent, recognizing that electronic communications may carry privacy risks.
Substance Use Disorder Records (42 CFR Part 2)
Use and Disclosure of Substance Use Disorder Records Subject to 42 CFR Part 2
If applicable, your substance use disorder (“SUD”) records are protected by federal law under 42 C.F.R. Part 2 (“Part 2”). This law provides extra confidentiality protections and requires a separate patient consent for the use and disclosure of SUD counseling notes. Each disclosure made with patient consent must include a copy of the consent or a clear explanation of the scope of the consent. It must also be accompanied by a written notice containing the language in 42 CFR Part 2.32(a). Disclosure of these records requires your explicit written consent, except in limited circumstances such as: (a) Medical Emergencies: to the extent necessary to treat you, (b) Reporting Crimes on Program Premises, (c) Child Abuse Reporting: In connection with incidents of suspected child abuse or neglect to appropriate state or local authorities, and (d) Fundraising: We will provide you with an opportunity to decline to receive any fundraising communications prior to making such communications. You may revoke this consent at any time.
Prohibitions on Use and Disclosure of Part 2 Records: SUD records received from programs subject to Part 2, or testimony relaying the content of such records, shall not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless based on your written consent, or a court order after notice and an opportunity to be heard is provided to you or the holder of the record, as provided in Part 2. A court order authorizing use or disclosure must be accompanied by a subpoena or other legal requirement compelling disclosure before the requested SUD record is used or disclosed. If SUD records are disclosed to us or our business associates pursuant to your written consent for treatment, payment, and healthcare operations, we or our business associates may further use and disclose such health information without your written consent to the extent that the HIPAA regulations permit such uses and disclosures, consistent with the other provisions in this Notice regarding PHI.
Reproductive Health Care Information Protections
The Practice is prohibited from using or disclosing PHI for the purpose of investigating, penalizing, or prosecuting any person for seeking, obtaining, providing, or facilitating lawful reproductive health care, including abortion, contraception, fertility care, or pregnancy-related services.
Example: We will not disclose records to law enforcement for the purpose of identifying a person who obtained lawful reproductive health care.
Attestation Requirement
For certain requests for PHI that may involve reproductive health information (including law enforcement, judicial, or health oversight requests), we must obtain a signed written attestation from the requester confirming that the information will not be used for a prohibited purpose.
Uses and Disclosures Without Authorization or Opportunity to Object
We may disclose PHI as permitted or required by law, including for:
- Public health and safety activities
- Health oversight, audits, and investigations
- Preventing a serious and imminent threat to health or safety
- Reporting abuse, neglect, or domestic violence
- Judicial and administrative proceedings
- Law enforcement requests (as permitted by law)
- National security and intelligence activities
- Workers’ compensation
- Coroners, medical examiners, and funeral directors
- Approved research
- Inmate care
- Business associates performing services on our behalf under HIPAA-compliant agreements
Uses and Disclosures with Opportunity to Object
Unless you object, we may share PHI with family members, friends, or others involved in your care when relevant or if it is in your best interest and you are unable to express a preference.
Uses and Disclosures Requiring Written Authorization
We must obtain your written authorization to use or disclose PHI for:
- Marketing
- Sale of PHI
- Psychotherapy notes (as defined by HIPAA)
You may revoke an authorization at any time in writing.
Fundraising Activities
The Practice does not engage in fundraising activities using your protected health information.
OUR RESPONSIBILITIES
We are required by law to:
- Maintain the privacy and security of PHI
- Follow the terms of this Notice currently in effect
- Comply with more stringent state or federal privacy laws when applicable
- Notify you following a breach of unsecured PHI
We reserve the right to change this Notice and make the revised Notice effective for all PHI we maintain. Updated Notices are available upon request and on our website.
Original Effective Date: April 14, 2003
Revised: December 2014; November 2017; May 2018
Revised: February 25, 2026