Surrender to Growth · Christa Goodale, LPC

Notice of Privacy Practices

Effective date: October 5, 2026

Our commitment to your privacy

Surrender to Growth ("we," "us," or "the practice") is required by law to keep your protected health information ("PHI") private, to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect. PHI is information that identifies you and relates to your past, present, or future physical or mental health, the care you receive, or payment for that care.

Therapy is provided online through secure, HIPAA-compliant video. Your records are kept in a secure electronic health record system. When Oklahoma or Texas law gives your information more protection than federal law, we follow the stricter law.

How we may use and share your information for treatment, payment, and health care operations

We may use and disclose your PHI without your written authorization for the following purposes:

• Treatment. To provide, coordinate, or manage your care. For example, with your knowledge, we may consult with your physician, psychiatrist, or another provider involved in your care.
• Payment. To bill and receive payment for services. For example, we may share your diagnosis, dates of service, and type of service with your health plan or a billing service that works on our behalf.
• Health care operations. To run the practice and maintain quality care. For example, for clinical consultation, quality review, audits, licensing, or legal and accounting services.
• Business associates. We contract with outside companies, such as electronic health record, telehealth, and billing providers, that need access to PHI to do their work. They are required by law and by contract to protect your information.
• Appointment reminders. We may contact you to remind you of appointments or share information about your care, using the contact methods you have approved.

Sharing with people involved in your care

If you agree, or if you are present and do not object, we may share information with a family member, friend, or other person you identify who is involved in your care or payment for your care. If you are not present or are unable to agree, such as in an emergency, we may use professional judgment to share only what is directly relevant.

Other uses and disclosures that do not require your authorization

The law allows or requires us to share PHI without your authorization in certain situations, including:

• When required by law, including state and federal law.
• Abuse, neglect, or exploitation. We are required to report suspected abuse or neglect of a child, and of an elderly person or vulnerable adult, to the appropriate authorities.
• Serious threat to health or safety. We may share information when necessary to prevent or lessen a serious and imminent threat to your safety or the safety of another person or the public.
• Public health activities, such as reporting to public health authorities as required by law.
• Health oversight activities, such as audits, investigations, or inspections by a licensing board or government agency.
• Lawsuits and legal proceedings, in response to a court order, or to a subpoena or other lawful request when required assurances have been provided and state law permits.
• Law enforcement, in limited circumstances permitted by law.
• Coroners and medical examiners, as permitted by law.
• Specialized government functions, such as military, national security, or protective services, as required by law.
• Workers' compensation, as authorized by and to the extent necessary to comply with workers' compensation laws.

When we need your written permission

Other than the uses described above, we will use or share your PHI only with your written authorization. In particular, your authorization is required for:

• Psychotherapy notes. Most uses and disclosures of psychotherapy notes, which are notes a therapist keeps separately from the rest of your record, require your authorization, except in the limited situations allowed by law.
• Marketing. We do not use or share your PHI for marketing without your authorization.
• Sale of PHI. We will never sell your PHI.

We do not engage in fundraising. You may revoke an authorization in writing at any time. Revoking it will not affect information already shared while the authorization was in effect.

Substance use disorder records

If we receive records protected by federal confidentiality rules for substance use disorder treatment (42 C.F.R. Part 2), those records receive additional protection. You may give a single consent for all future uses and disclosures of these records for treatment, payment, and health care operations, and you may revoke that consent in writing at any time. Records shared under such a consent may not be further disclosed except as allowed by law. Part 2 records, or testimony about their contents, will not be used or disclosed in a civil, criminal, administrative, or legislative proceeding against you unless you give specific written consent or a court issues an order that meets Part 2 requirements.

Electronic disclosure (Texas)

Please be aware that your PHI may be shared electronically, for example with your health plan for billing, or with other providers for treatment, as permitted by law. For Texas clients, we do not disclose your PHI electronically for purposes other than treatment, payment, health care operations, or as otherwise authorized or required by law without your authorization.

Your rights regarding your health information

• Right to see and get a copy of your records. You may ask to see or get an electronic or paper copy of your health and billing records. We will respond within the time required by law and may charge a reasonable, cost-based fee. In limited circumstances, access may be denied, and you may request a review of that decision. Psychotherapy notes are not included in this right.
• Right to request a correction. You may ask us to correct information you believe is incorrect or incomplete. We may say no, but we will explain why in writing within 60 days.
• Right to request confidential communications. You may ask us to contact you in a specific way, such as a certain phone number or email address, or by mail to a different address. We will agree to all reasonable requests.
• Right to request limits on what we use or share. You may ask us not to use or share certain information. We are not required to agree, except in this case: if you pay for a service in full out of pocket, you may ask us not to share information about that service with your health plan, and we will agree unless the law requires us to share it.
• Right to a list of disclosures. You may ask for a list (accounting) of the times we have shared your PHI for up to six years before your request, who we shared it with, and why. This list does not include disclosures for treatment, payment, or health care operations, or those you authorized. We will provide one list a year for free.
• Right to a copy of this notice. You may ask for a paper copy of this notice at any time, even if you agreed to receive it electronically.
• Right to choose someone to act for you. If you have given someone medical power of attorney, or someone is your legal guardian, that person can exercise your rights and make choices about your health information.
• Right to be notified of a breach. We will notify you if a breach occurs that may have compromised the privacy or security of your PHI.

To exercise any of these rights, contact us using the information below. Some requests must be made in writing.

Our duties

• We are required by law to maintain the privacy and security of your PHI.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing.

Changes to this notice

We may change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available on this website and upon request.

A note about email and text messages

Email and text messages are not always fully secure. If you choose to communicate with us by email or text, we will treat those messages as part of your record. Please avoid sharing detailed personal health information by email or text, and never use them in an emergency.

Questions and complaints

If you have questions about this notice, want to exercise your rights, or believe your privacy rights have been violated, please contact our Privacy Officer:

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, by visiting hhs.gov/ocr/complaints, calling 1-877-696-6775, or writing to 200 Independence Avenue S.W., Washington, D.C. 20201.

You may also contact the licensing board in your state: the Oklahoma State Board of Behavioral Health, or the Texas Behavioral Health Executive Council.

We will not retaliate against you in any way for filing a complaint.

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