Notice of Privacy Practices
Lilac Family Counseling, PLLC
Effective Date: 2/22/2026
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.
Lilac Family Counseling PLLC is committed to protecting the privacy and confidentiality of your Protected Health Information (PHI). This Notice describes how we may use and disclose your health information and your rights regarding that information under the Health Insurance Portability and Accountability Act (HIPAA).
How We May Use and Disclose Your Health Information
1. For Treatment
We may use and disclose your health information to provide, coordinate, or manage your mental health treatment.
Examples:
- Consulting with another healthcare provider (with proper authorization when required)
- Coordinating care with your child’s pediatrician or psychiatrist
2. For Payment
Although Lilac Family Counseling is currently self-pay, we may use your health information:
- To provide you with a Superbill upon request
- To process payment
- To collect outstanding balances
3. For Health Care Operations
We may use your information for:
- Practice management
- Quality improvement
- Compliance reviews
- Scheduling and administrative purposes
4. Appointment Reminders & Communication
We may contact you by:
- Phone
- Text message
For appointment reminders or administrative matters. By providing your contact information, you consent to these communications. Please note that electronic communication may not always be secure.
5. Required by Law
We may disclose health information when required by federal or state law, including:
- Suspected child abuse or neglect
- Threats of serious harm to self or others
- Court orders or subpoenas
- Public health requirements
Uses and Disclosures Requiring Authorization
We will obtain your written authorization before:
- Releasing therapy records to third parties (except as required by law)
- Disclosing psychotherapy notes
- Using your information for marketing purposes
You may revoke authorization at any time in writing.
Your Rights Regarding Your Health Information
You have the right to:
1. Access Your Records
Request copies of your health records (with limited exceptions).
2. Request Amendments
Ask us to correct inaccurate or incomplete information.
3. Request Restrictions
Request limits on how we use or disclose your information (though we are not always required to agree).
4. Request Confidential Communications
Request that we contact you in a specific way (for example, only by cell phone).
5. Receive an Accounting of Disclosures
Request a list of certain disclosures we have made.
6. Receive a Paper Copy of This Notice
You may request a copy at any time.
Our Responsibilities
Lilac Family Counseling is required by law to:
- Maintain the privacy of your health information
- Provide you with this Notice
- Follow the terms currently in effect
- Notify you in the event of a breach of unsecured protected health information
We reserve the right to change this Notice at any time. Updated versions will be posted on our website and available upon request.
Questions or Complaints
If you believe your privacy rights have been violated, you may file a complaint with:
Lilac Family Counseling, PLLC
300 S. Ardmore Villa Park IL
Info@lilacfamilycounseling.com
630-296-4060
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. Filing a complaint will not affect your care in any way.
Acknowledgment of Receipt
Clients will be asked to sign an acknowledgment form confirming receipt of this Notice.