​I. INTRODUCTION

Embodied Resilience Therapy, LLC is committed to protecting your privacy. We are required by law to maintain the confidentiality of your Protected Health Information (PHI), to provide you with this Notice of our legal duties and privacy practices, and to notify you in the event of a breach involving your PHI.

PHI includes any information about your past, present, or future physical or mental health that can be used to identify you and that relates to your care or payment for that care.

We may update this Notice at any time, and revised versions will apply to all records we maintain. You may request a copy of the current Notice at any time.

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II. OUR PLEDGE TO YOU

We respect the privacy of your health information. This Notice outlines how your PHI may be used and disclosed for treatment, payment, operations, and other purposes permitted or required by law. It also explains your rights regarding your PHI.

This Notice applies to all services provided by Elizabeth Martinez, LCSW, and any staff or contractors working under Embodied Resilience Therapy, LLC.

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III. USES AND DISCLOSURES OF YOUR PHI

A. Routine Uses

We may use or disclose your PHI for the following reasons without additional authorization:

• Treatment: To provide or coordinate your mental health care (e.g., consultations with other providers, referral letters).

• Payment: To bill and obtain reimbursement from insurance or other payers.

• Healthcare Operations: For practice management and quality improvement purposes (e.g., audits, licensing, compliance).

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B. Situations Where Use/Disclosure Is Permitted Without Authorization

• Family members involved in care (if you do not object)

• Public health and safety (e.g., abuse reporting, communicable diseases)

• Law enforcement or court orders

• Health oversight (e.g., audits, licensing boards)

• Workers’ compensation cases

• National security and military

• Research (with oversight board approval)

• Organ/tissue donation

• Death and funeral-related disclosures

• Notification of family in emergencies

• To prevent or lessen a serious threat to you or others

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C. Alcohol/Drug Treatment Disclosures

PHI related to substance use treatment is subject to stricter federal laws under 42 C.F.R. Part 2 and will only be disclosed with your written consent or as required by law.

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IV. OTHER USES REQUIRING YOUR AUTHORIZATION

We will not use or disclose your PHI for marketing, fundraising, or sell your information without your written authorization. Any other use or disclosure not listed in this Notice will only be made with your written permission. You may revoke that authorization at any time in writing.

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V. YOUR RIGHTS

You have the right to:

• Access Your Records: Request to inspect or receive a copy of your PHI.

• Request Amendments: Ask for corrections to your PHI.

• Request Restrictions: Ask us not to use or disclose certain parts of your PHI.

• Request Confidential Communications: Ask to be contacted in a specific way (e.g., only via email or phone).

• Receive an Accounting of Disclosures: Ask for a list of when and why your PHI was shared (excludes routine disclosures).

• Receive Notification of a Breach: Be informed if your PHI is ever compromised.

• Obtain a Paper Copy of This Notice: Even if you received this electronically.

All requests must be submitted in writing to the contact listed below.​

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VI. COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with:

• Embodied Resilience Therapy, LLC: (210) 709-9272 | info@embodiedresiliencetherapy.com

• U.S. Department of Health and Human Services

• Texas Behavioral Health Executive Council

There will be no retaliation for filing a complaint.

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VII. CONTACT INFORMATION

If you have questions or want to request your privacy rights, contact:

Privacy Official: Elizabeth Martinez, LCSW
Embodied Resilience Therapy, LLC
Website: https://embodiedresiliencetherapy.com
Phone: (210) 709-9272 | Email: info@embodiedresiliencetherapy.com