HIPPA Notice of Privacy Practices
This Notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. You have the right to receive this Notice in plain language.
Your Rights
You have the right to:
Get a copy of your health and claims records
Correct your health and claims records
Request confidential communication
Ask us to limit the information we share
Get a list of those with whom we’ve shared your information
Get a copy of this privacy notice
Choose someone to act for you
File a complaint if you believe your privacy rights have been violated
Your Choices
You have some choices in the way we use and share information as we:
Tell family and friends about your condition
Provide disaster relief
Include you in a hospital directory
Provide mental health care
Market our services and sell your information
Raise funds
For these uses and disclosures, you may tell us your preferences. If you are not able to tell us your preference, for example if you are unconscious, we may share your information if we believe it is in your best interest.
Our Uses and Disclosures
How do we typically use or share your health information?
We typically use or share your health information in the following ways:
Treat you. We can use your health information and share it with other professionals who are treating you. Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Run our organization. We can use and share your health information to run our practice, improve your care, and contact you when necessary. Example: We use health information about you to manage your treatment and services.
Bill for your services. We can use and share your health information to bill and get payment from health plans or other entities. Example: We give information about you to your health insurance plan so it will pay for your services. Note: This practice does not bill insurance directly. Payment is due at time of service.
How else can we use or share your health information?
We are allowed or required to share your information in other ways — usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html
Help with public health and safety issues. We can share health information about you for certain situations such as: preventing disease, helping with product recalls, reporting adverse reactions to medications, reporting suspected abuse, neglect, or domestic violence, and preventing or reducing a serious threat to anyone’s health or safety.
Do research. We can use or share your information for health research.
Comply with the law. We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests. We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director. We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests. We can use or share health information about you: for workers’ compensation claims, for law enforcement purposes or with a law enforcement official, with health oversight agencies for activities authorized by law, and for special government functions such as military, national security, and presidential protective services.
Respond to lawsuits and legal actions. We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Special Protections for Mental Health Information
As a mental health practice in the State of Texas, additional protections apply to your health information beyond standard HIPAA requirements. Mental health records receive heightened protection under Texas law. Your mental health information will not be shared without your written authorization except as required or permitted by law.
Our Responsibilities
We are required to:
Maintain the privacy and security of your protected health information
Notify you promptly if a breach occurs that may have compromised the privacy or security of your information
Follow the duties and privacy practices described in this notice and give you a copy of it
Not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html
Changes to the Terms of This Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website at aimforhealingtherapy.com.
Your Right to Limit Disclosures
You have the right to request that we restrict or limit the health information we use or disclose about you. We are not required to agree to your request unless you are asking us to restrict disclosures to a health plan for services for which you paid out-of-pocket in full. If we agree, we will comply with your request unless the information is needed to provide you emergency treatment.
To request a restriction, submit a written request to: info@aimforhealingtherapy.com or mail to: Aim for Healing Therapy, PLLC, 1325 Main Street, Unit 501, Katy, TX 77494.
Complaints
If you feel that we have violated your privacy rights, you have the right to file a complaint with us or with the Secretary of the Department of Health and Human Services. We will not retaliate against you for filing a complaint.
To file a complaint with us, contact:
Name: RA’SHUNDA ADAMS
Address: 1325 Main Street, Unit 501, Katy, TX 77494
Phone: 832-617-4010
Email: info@aimforhealingtherapy.com
To file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights, send a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, call 1-877-696-6775, or visit www.hhs.gov/ocr/privacy/hipaa/complaints/
Contact Us
For any questions regarding this Notice, please contact:
Practice: Aim for Healing Therapy, PLLC
Therapist: Ra’Shunda Adams, LMFT-Associate
Supervised by: Dr. Mercedes Moore, PhD, LMFT-S & Dr. Ashley Staats, PhD, LMFT-S
Address: 1325 Main Street, Unit 501, Katy, TX 77494
Phone: 832-617-4010
Email: info@aimforhealingtherapy.com
Website: aimforhealingtherapy.com
Last Updated April 2026