Notice of Privacy Practices

Brightside Counseling LLC
Effective Date: August 28, 2026

Who Follows This Notice

This Notice describes the privacy practices of Brightside Counseling LLC (“Brightside,” “we,” “us,” or “our”) and applies to everyone who works for or on behalf of the practice, including:

• Psychiatrists, nurse practitioners, and other prescribing clinicians;
• Therapists, counselors, social workers, and behavioral health specialists;
• Nurses and clinical support staff;
• Students, interns, and trainees working under the supervision of a Brightside clinician;
• Administrative, billing, scheduling, and front-office staff;
• Contractors and volunteers acting under our direction.

It applies to care you receive at our office at 681 Harleysville Pike, 2nd Floor, Harleysville, PA 19438, in our Partial Hospitalization and Intensive Outpatient Programs, and through telehealth.

Independent clinicians who are not employed by or contracted with Brightside maintain their own records and follow their own privacy notices.

Our Pledge Regarding Your Health Information

We understand that information about you and your mental health is deeply personal. We create and keep a record of the care and services you receive from us. We need that record to provide you with quality care and to meet legal and professional requirements.

We are required by law to:

• Keep health information that identifies you private;
• Give you this Notice of our legal duties and privacy practices regarding your health information;
• Follow the terms of the Notice currently in effect;
• Notify you if a breach occurs that compromises the privacy or security of your health information.

We will not use or disclose your health information without your written authorization except as described in this Notice or as otherwise permitted or required by law.

Special Protections for Mental Health Information

Because we provide behavioral health care, some of your information receives protection beyond what federal privacy law requires. Where Pennsylvania law or another law is more protective than HIPAA, we follow the more protective rule.

Psychotherapy notes. Notes a clinician records to document or analyze the contents of a counseling session, kept separate from the rest of your record, receive special protection. We will not use or disclose psychotherapy notes without your written authorization, except in the narrow circumstances federal law allows, such as our own training of clinicians, defending ourselves in a legal action you bring, or averting a serious and imminent threat to health or safety. We will not condition your treatment on whether you sign an authorization for psychotherapy notes.

Pennsylvania mental health confidentiality law. Pennsylvania places additional restrictions on the release of mental health treatment records. In many situations we must obtain your written consent even where HIPAA alone would permit a disclosure.

Substance use disorder treatment records. Records of substance use disorder diagnosis, treatment, or referral that are subject to federal confidentiality regulations receive additional protection. Those records generally may not be disclosed or redisclosed without your specific written consent, and a general medical release is not sufficient.

HIV-related information. Pennsylvania law separately restricts the disclosure of HIV-related information, and we follow those restrictions.

Genetic information. We do not use or disclose your genetic information, including results of any pharmacogenetic testing arranged through us, for underwriting purposes.

Minors and Personal Representatives

Minors 14 and older. Pennsylvania law allows a minor who is 14 or older to consent to their own outpatient mental health treatment. Where a minor has consented to treatment on their own, records of that treatment are generally protected from release to a parent or guardian without the minor’s permission, subject to limited exceptions under the law.

Parents and guardians. A parent or legal guardian may also consent to outpatient mental health treatment for a minor under 18. In most cases a parent or guardian is the minor’s “personal representative” and may exercise the rights described in this Notice on the minor’s behalf.

We may decline to treat a parent, guardian, or other person as a personal representative when the law provides otherwise, or when we reasonably believe, in the exercise of professional judgment, that doing so could endanger the patient — for example, where there is a concern about abuse or neglect.

Other personal representatives. If you have a health care power of attorney, guardian, or executor, we will treat that person as you with respect to the information they are authorized to receive, after we verify their authority.

How We May Use and Disclose Your Health Information

The categories below describe the ways we may use and disclose your health information. Not every use or disclosure is listed, but every use or disclosure we make falls within one of these categories or is otherwise permitted or required by law.

For Treatment

We may use your health information to provide and coordinate your care, and disclose it to those involved in your care. For example, your therapist and your prescriber may discuss your symptoms and medications; we may coordinate with your primary care physician, a hospital, or a referring provider; we may share information within your Partial Hospitalization or Intensive Outpatient Program treatment team; and we may communicate with a laboratory or pharmacy. Disclosures to providers outside Brightside are made consistent with the mental health confidentiality protections described above.

For Payment

We may use and disclose your health information to bill and collect payment for the care we provide. For example, we may verify your insurance eligibility and benefits, obtain prior authorization for a service, submit claims, respond to a payer’s request for records to support a claim, and pursue unpaid balances.

If you pay in full, out of pocket, for a service, you have the right to ask us not to send information about that service to your health plan, and we must honor that request. See “Right to request restrictions” below.

For Health Care Operations

We may use and disclose your health information to run the practice and support the quality of care, including:

• Quality assessment and improvement activities and case review;
• Clinical supervision and review of the work of our clinicians, students, and trainees;
• Training clinicians, students, and trainees;
• Credentialing, licensing, accreditation, and professional review;
• Care coordination and care management;
• Business planning, administration, auditing, and compliance activities;
• Consulting with our attorneys, accountants, and other professional advisors.

Wherever practical we use information from which identifying details have been removed.

Appointment Reminders and Care Communications

We may use your health information and the contact information you give us to remind you of appointments, follow up on missed appointments, and communicate about your care. If we cannot reach you, we may leave a message with the person who answers or on voicemail.

If you have chosen to receive text messages or email from us, we may send reminders and notifications by those methods. Text message and email are not fully secure, and you may withdraw that choice at any time by telling us. You may also ask us to communicate with you only in a particular way or at a particular location — see “Right to request confidential communications” below.

Treatment Alternatives and Health-Related Benefits

We may contact you to tell you about treatment options, programs, or health-related services that may be of interest to you, including our own programs.

Individuals Involved in Your Care

Unless you object, we may share with a family member, friend, or other person you identify the information directly relevant to that person’s involvement in your care or in payment for your care. If you are not present or are unable to agree or object, we may use professional judgment to determine whether the disclosure is in your best interest, and share only what is directly relevant.

Business Associates

We use outside vendors to perform certain services for us — for example, our electronic health record and patient portal, our billing and clearinghouse services, our telehealth platform, laboratory and testing services, information technology support, and secure document destruction. We may disclose your health information to these vendors so they can perform those services. Each is required by written agreement to safeguard your information and to use it only for the purposes we permit.

As Required by Law

We will disclose your health information when federal, state, or local law requires it.

To Avert a Serious Threat to Health or Safety

We may use or disclose your health information when necessary to prevent or lessen a serious and imminent threat to your health or safety or to the health or safety of another person. Disclosure would be made only to someone able to help prevent or lessen the threat. Pennsylvania law may require a clinician to warn an identifiable person whom a patient has threatened with serious bodily harm, or to notify law enforcement.

Abuse, Neglect, and Domestic Violence

Our clinicians are mandated reporters. We are required by law to report suspected abuse or neglect of a child, and suspected abuse, neglect, exploitation, or abandonment of an older adult or care-dependent person, to the appropriate authorities. We may also disclose information about suspected victims of abuse, neglect, or domestic violence as the law permits or requires.

Public Health Activities

We may disclose your health information for public health purposes, including to prevent or control disease or injury, to report births and deaths, to report reactions to medications or problems with products, to notify people of product recalls, and to notify a person who may have been exposed to or be at risk of spreading a disease or condition.

Health Oversight Activities

We may disclose your health information to a health oversight agency for activities authorized by law, such as audits, investigations, inspections, licensure, and disciplinary actions. These activities allow the government to monitor the health care system, government programs, and compliance with civil rights laws.

Lawsuits and Disputes

If you are involved in a lawsuit or a dispute, we may disclose your health information in response to a court or administrative order. We may also respond to a subpoena, discovery request, or other lawful process, but only after reasonable efforts have been made to notify you or to obtain a protective order. Mental health records receive additional protection in legal proceedings under Pennsylvania law.

Law Enforcement

We may disclose your health information to a law enforcement official:

• In response to a court order, subpoena, warrant, summons, or similar process;
• To identify or locate a suspect, fugitive, material witness, or missing person;
• About a victim of a crime, in limited circumstances, if we are unable to obtain the person’s agreement;
• About a death we believe may have resulted from criminal conduct;
• About criminal conduct on our premises;
• In an emergency, to report a crime, its location or victims, or the identity or description of the person who committed it.

Coroners, Medical Examiners, and Funeral Directors

We may release health information to a coroner or medical examiner, for example to identify a deceased person or determine cause of death, and to funeral directors as necessary for them to carry out their duties.

Workers’ Compensation

We may release health information as authorized by workers’ compensation or similar programs that provide benefits for work-related injuries or illness.

Military, Veterans, National Security, and Correctional Institutions

If you are a member of the armed forces, we may release health information as required by military command authorities. We may release health information to authorized federal officials for national security and intelligence activities and for protective services. If you are an inmate of a correctional institution or in the custody of a law enforcement official, we may release health information to that institution or official as the law permits.

Deceased Individuals

We may disclose health information about a deceased person as permitted by law, including to a personal representative of the estate or, in limited circumstances, to family members involved in the person’s care before death.

Uses and Disclosures That Require Your Written Authorization

The following require your written authorization:

• Most uses and disclosures of psychotherapy notes;
• Marketing communications, where we would receive payment from a third party in exchange for making them;
• Any sale of your health information;
• Any other use or disclosure not described in this Notice or otherwise permitted or required by law.

We do not sell your health information.

If you give us an authorization, you may revoke it in writing at any time. A revocation stops future uses and disclosures for the purposes covered by that authorization. It cannot undo disclosures we already made in reliance on it, and we are required to keep the records of the care we provided to you.

Your Rights Regarding Your Health Information

To exercise any of these rights, submit a written request to the Privacy Officer at the address at the end of this Notice. We will provide the form you need.

Right to inspect and copy. You may inspect and obtain a copy of the health information we use to make decisions about your care. If we keep your record electronically, you may request an electronic copy, and you may direct us to send a copy to a person or entity you designate. We will respond within 30 days and may extend that period once by 30 days with written notice to you. We may charge a reasonable, cost-based fee for copying, mailing, and supplies.

In limited circumstances we may deny access — for example, to psychotherapy notes, to information compiled for a legal proceeding, or where a licensed health care professional determines that access is reasonably likely to endanger you or another person. If access is denied on that last basis, you may request review of the denial by another licensed health care professional who was not involved in the original decision, and we will abide by the outcome of that review.

Right to request an amendment. If you believe information in your record is incorrect or incomplete, you may ask us to amend it for as long as we keep the information. Your request must be in writing and must state the reason supporting it. We may deny your request if the information was not created by us (unless its creator is no longer available), is not part of the records we keep, is not information you would be permitted to inspect and copy, or is accurate and complete. If we deny your request, you may submit a written statement of disagreement that we will include with the information.

Right to an accounting of disclosures. You may request a list of certain disclosures we made of your health information — those other than for treatment, payment, health care operations, disclosures you authorized, and several other categories the law excludes. Your request may cover a period of up to six years, and may not include dates before the effective date of this Notice. The first list you request in any 12-month period is free; for additional lists we may charge a cost-based fee, and we will tell you the cost in advance so you can withdraw or modify your request.

Right to request restrictions. You may ask us to limit how we use or disclose your health information for treatment, payment, or health care operations, or to limit what we disclose to someone involved in your care. We are not required to agree to most requested restrictions, but if we do agree, we will honor the restriction except when the information is needed to provide you emergency treatment. Any agreement to a restriction must be in writing and signed by the Privacy Officer to be binding.

We are required to agree to one restriction: if you pay in full, out of pocket, for a service, and you ask us not to disclose information about that service to your health plan for payment or health care operations purposes, we must honor that request, unless the law requires the disclosure.

Right to request confidential communications. You may ask us to communicate with you about medical matters in a specific way or at a specific location — for example, only by mail, only at a particular phone number, or only at work. We will accommodate all reasonable requests, and we will not ask you why. Your request must be in writing and must specify how or where you wish to be contacted.

Right to be notified of a breach. You have the right to be notified if a breach occurs involving your unsecured health information.

Right to a paper copy of this Notice. You may ask for a paper copy at any time, even if you agreed to receive this Notice electronically. This Notice is also posted at our office and on our website at brightsidecounseling.org.

Right to choose someone to act for you. If you have given someone medical power of attorney, or if someone is your legal guardian, that person may exercise these rights and make choices about your health information. We will verify their authority before acting.

Right to complain. You may complain without fear of retaliation — see below.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer using the contact information below, or with the Secretary of the U.S. Department of Health and Human Services:

Office for Civil Rights, U.S. Department of Health and Human Services
200 Independence Avenue SW, Washington, D.C. 20201
1-877-696-6775 · hhs.gov/ocr/privacy/hipaa/complaints

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

Changes to This Notice

We reserve the right to change this Notice at any time, and to make the revised Notice effective for health information we already have about you as well as information we receive in the future. The current Notice will be posted at our office and on our website, will show its effective date, and is available from us on request.

Contact Us

Privacy Officer
Brightside Counseling LLC
681 Harleysville Pike, 2nd Floor
Harleysville, PA 19438
Phone: (215) 264-2272
Fax: (215) 827-5159
Email: brightsidecounselingpa@gmail.com

Effective Date: August 28, 2026.