Notice of Privacy Practices

I take your privacy seriously, not because a regulation tells me to, but because trust is the foundation of any therapeutic relationship. This notice explains, in plain language, how I handle your health information and what rights you have regarding it.

Who This Notice Covers

This notice applies to Jared Tawney, LMFT, practicing as Ascalon Counseling (a DBA of Bristol Ave PLLC), licensed in Washington (LF61526523) and Idaho. It covers all protected health information (PHI) I create or receive in the course of providing couples, family, and individual therapy, and clinical supervision.

How I May Use and Disclose Your Health Information

Federal law allows me to use and disclose your PHI without your written authorization for the following purposes:

Treatment

I use your information to provide, coordinate, and manage your care. If you're in couples or family therapy, this includes information shared in joint sessions, which I may reference in the course of treatment for the unit as a whole. If you see another provider for a referral or consultation related to your care, I may share relevant information with your consent.

Payment

If you use insurance through Headway, I share the information necessary to bill and receive payment for services, including diagnosis, dates of service, and treatment type. If you self-pay, this section largely does not apply to you.

Healthcare Operations

This includes activities like quality review, professional consultation with colleagues (without identifying you when possible), supervision of associate clinicians, and administrative functions necessary to run the practice.

Other Permitted or Required Disclosures

In limited circumstances, I may be permitted or required by law to disclose your information without your authorization, including:

• Risk of serious harm. If I believe you present a serious danger to yourself or another identifiable person, I am permitted, and in some cases required, to take protective action, which may include notifying the potential victim, a family member, or law enforcement.
• Abuse or neglect. If you disclose the abuse, neglect, or exploitation of a child, elder, or dependent adult, I am a mandated reporter under Washington and Idaho law and must report to the appropriate agency.
• Court order. If a court of competent jurisdiction orders me to disclose information, I am required to comply, though I will make reasonable efforts to notify you first where legally permitted.
• Health oversight and licensing. The Washington Department of Health and the Idaho Division of Occupational and Professional Licenses may review records in connection with a licensing complaint or investigation.
• Public health and safety. Limited disclosures may be required to prevent or control disease, injury, or disability, or to report certain communicable conditions.

For any use or disclosure not described above, including most disclosures of psychotherapy notes, I will ask for your written authorization, which you may revoke at any time.

Psychotherapy Notes

Process notes I keep for my own clinical use, separate from your official record, receive heightened protection under HIPAA. I will not disclose these notes without your specific written authorization, except where required by law.

Substance Use Disorder Records

If your care involves records related to a substance use disorder that fall under federal confidentiality protections (42 CFR Part 2), those records carry additional restrictions on redisclosure beyond standard HIPAA protections. Information you share about substance use in the context of general mental health treatment is protected under this notice; I will explain any additional consent requirements that apply if Part 2 protections come into play in your specific care.

Your Rights

You have the right to:

• Request restrictions on how your information is used or disclosed, though I am not required to agree to every request.
• Request confidential communications, such as being contacted only at a certain phone number or email address.
• Inspect and obtain a copy of your health record, with limited exceptions (for example, I may deny access to psychotherapy notes).
• Request an amendment to your record if you believe it is inaccurate or incomplete.
• Receive an accounting of disclosures I have made of your PHI outside of treatment, payment, and healthcare operations.
• Receive a paper copy of this notice at any time, even if you agreed to receive it electronically.
• File a complaint if you believe your privacy rights have been violated, without fear of retaliation.

My Responsibilities

I am required to maintain the privacy of your PHI, provide you with this notice describing my legal duties and privacy practices, and abide by the terms currently in effect. I reserve the right to change the terms of this notice and to make the revised notice effective for all PHI I maintain. If I make material changes, an updated version will be posted here with a new effective date.

How to File a Complaint

If you believe your privacy rights have been violated, you may file a complaint with me directly, or with the U.S. Department of Health and Human Services Office for Civil Rights. You will not be penalized for filing a complaint.

Questions Before You Begin Care

If anything here is unclear, ask me. I would rather take five minutes to explain how your information is handled than have you walk into our first session with unanswered questions about privacy.