Notice of Privacy Practices (NPP)
Bluestem Therapy, LLC
Effective Date: September 20, 2025
THIS NOTICE DESCRIBES HOW YOUR PROTECTED HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
I understand that your health information is personal. I am committed to protecting your privacy and complying with all applicable federal and state privacy laws, including the Health Insurance Portability and Accountability Act (HIPAA). This notice applies to all records of your care with me.
My Pledge Regarding Your Health Information
The law requires me to:
Keep your protected health information (PHI) private.
Provide you with this notice of my legal duties and privacy practices.
Follow the terms of this notice.
Potential for Redisclosure: Please be aware that once your health information is disclosed in a permitted way (such as to an insurance company), it may be redisclosed by the recipient and may no longer be protected by federal privacy laws, although it may still be protected by applicable state laws.
I may change the terms of this notice, and any changes will apply to all information I have about you. An updated notice will be available to you in that case.
How I May Use and Disclose Your Health Information
For your care, I may use or disclose your PHI without your written authorization for Treatment, Payment, or Health Care Operations.
Treatment: I may share your information with a consulting colleague or other licensed healthcare providers for consultation to ensure best practices and quality of care. These consultations will not involve the disclosure of identifying information.
Payment: This includes activities necessary to process payments for services, whether you are using insurance or paying privately.
Health Care Operations: This includes activities necessary for my business, such as clinical supervision, maintaining client records, and complying with legal or regulatory requirements.
Special Protections for Substance Use Disorder (SUD) Records: To the extent that I receive or maintain substance use disorder patient records (protected under 42 CFR Part 2), those records are subject to heightened confidentiality protections. I will not use or disclose these records in civil, criminal, administrative, or legislative proceedings against you without your specific written consent or a court order.
Certain Uses and Disclosures Require Your Authorization
Psychotherapy Notes: Any use or disclosure of my psychotherapy notes requires your specific written authorization, except for the following limited circumstances:
My own use for treating you.
Supervision or training of mental health professionals.
Defending myself in legal proceedings initiated by you.
Required legal or regulatory compliance.
Averting a serious threat to health or safety.
Marketing and Sale of PHI: I do not use or disclose your PHI for marketing purposes or sell your PHI.
Certain Uses and Disclosures Do Not Require Your Authorization
I may use and disclose your PHI without your authorization for:
Legal Compliance: When required by federal or state law.
Public Health: To prevent or control disease or report suspected abuse.
Law Enforcement: As required by a court order, subpoena, or in response to a lawful request from law enforcement.
Serious Threat to Health or Safety: If I believe disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
Judicial and Administrative Proceedings: In response to a court or administrative order.
Your Rights Regarding Your PHI
Right to Request Limits: You may request restrictions on how your PHI is used or disclosed. While I am not required to agree to all requests, I will consider all reasonable ones.
Right to Confidential Communications: You can request that I contact you about your care in a specific way or at a different location. I will accommodate all reasonable requests.
Right to Access Your PHI: You have the right to request an electronic or paper copy of your medical record (excluding my psychotherapy notes).
Right to an Accounting of Disclosures: You have the right to request a list of certain disclosures I have made of your PHI.
Right to Request Corrections: If you believe there is an error in your record, you may request that it be corrected.
Right to a Paper Copy of This Notice: You may request a paper or electronic copy of this notice at any time.
Questions or Complaints
If you believe your privacy rights have been violated, or if you have questions about this notice, please contact:
Maegan McRoberts, LICSW Bluestem Therapy, LLC 300 Century Park S Birmingham, AL 35226 Phone: (205)931-5111
You may also file a complaint with the U.S. Department of Health and Human Services. You will not be penalized for filing a complaint.
Client Acknowledgment
By signing below, I acknowledge that I have received, read, and understand the Notice of Privacy Practices.Notice of Privacy Practices (NPP)
Bluestem Therapy, LLC
Notice of Privacy Practices
Effective Date: September 20, 2025
THIS NOTICE DESCRIBES HOW YOUR PROTECTED HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
I understand that your health information is personal. I am committed to protecting your privacy and complying with all applicable federal and state privacy laws, including the Health Insurance Portability and Accountability Act (HIPAA). This notice applies to all records of your care with me.
My Pledge Regarding Your Health Information
The law requires me to:
Keep your protected health information (PHI) private.
Provide you with this notice of my legal duties and privacy practices.
Follow the terms of this notice.
Potential for Redisclosure: Please be aware that once your health information is disclosed in a permitted way (such as to an insurance company), it may be redisclosed by the recipient and may no longer be protected by federal privacy laws, although it may still be protected by applicable state laws.
I may change the terms of this notice, and any changes will apply to all information I have about you. An updated notice will be available to you in that case.
How I May Use and Disclose Your Health Information
For your care, I may use or disclose your PHI without your written authorization for Treatment, Payment, or Health Care Operations.
Treatment: I may share your information with a consulting colleague or other licensed healthcare providers for consultation to ensure best practices and quality of care. These consultations will not involve the disclosure of identifying information.
Payment: This includes activities necessary to process payments for services, whether you are using insurance or paying privately.
Health Care Operations: This includes activities necessary for my business, such as clinical supervision, maintaining client records, and complying with legal or regulatory requirements.
Special Protections for Substance Use Disorder (SUD) Records: To the extent that I receive or maintain substance use disorder patient records (protected under 42 CFR Part 2), those records are subject to heightened confidentiality protections. I will not use or disclose these records in civil, criminal, administrative, or legislative proceedings against you without your specific written consent or a court order.
Certain Uses and Disclosures Require Your Authorization
Psychotherapy Notes: Any use or disclosure of my psychotherapy notes requires your specific written authorization, except for the following limited circumstances:
My own use for treating you.
Supervision or training of mental health professionals.
Defending myself in legal proceedings initiated by you.
Required legal or regulatory compliance.
Averting a serious threat to health or safety.
Marketing and Sale of PHI: I do not use or disclose your PHI for marketing purposes or sell your PHI.
Certain Uses and Disclosures Do Not Require Your Authorization
I may use and disclose your PHI without your authorization for:
Legal Compliance: When required by federal or state law.
Public Health: To prevent or control disease or report suspected abuse.
Law Enforcement: As required by a court order, subpoena, or in response to a lawful request from law enforcement.
Serious Threat to Health or Safety: If I believe disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
Judicial and Administrative Proceedings: In response to a court or administrative order.
Your Rights Regarding Your PHI
Right to Request Limits: You may request restrictions on how your PHI is used or disclosed. While I am not required to agree to all requests, I will consider all reasonable ones.
Right to Confidential Communications: You can request that I contact you about your care in a specific way or at a different location. I will accommodate all reasonable requests.
Right to Access Your PHI: You have the right to request an electronic or paper copy of your medical record (excluding my psychotherapy notes).
Right to an Accounting of Disclosures: You have the right to request a list of certain disclosures I have made of your PHI.
Right to Request Corrections: If you believe there is an error in your record, you may request that it be corrected.
Right to a Paper Copy of This Notice: You may request a paper or electronic copy of this notice at any time.
Questions or Complaints
If you believe your privacy rights have been violated, or if you have questions about this notice, please contact:
Maegan McRoberts, LICSW Bluestem Therapy, LLC 300 Century Park S Birmingham, AL 35226 Phone: (205)931-5111
You may also file a complaint with the U.S. Department of Health and Human Services. You will not be penalized for filing a complaint.
Client Acknowledgment
By signing below, I acknowledge that I have received, read, and understand the Notice of Privacy Practices.