Notice of Privacy Practices
Effective Date: 10/1/2026
Last Updated: 10/8/2026
Electronic Copy available for download here
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.
This Notice applies to protected health information (PHI) maintained by Becomingness Therapy and Consulting LLC in connection with psychotherapy and related health care services. It explains your privacy rights, my legal duties, and how your health information may be used or disclosed.Wisconsin law may provide additional protections for mental health treatment records. When Wisconsin or other applicable law is more protective of your information than HIPAA, I will follow the more protective law. 1. Your Rights
When it comes to your health information, you have certain rights. This section explains those rights and some of my responsibilities to help you exercise them.Get an electronic or paper copy of your record
You may ask to inspect or receive an electronic or paper copy of your medical record and other health information I maintain about you. Ask me how to make a request.I will generally provide access within the time required by law and may charge a reasonable, cost-based fee when permitted.
Ask me to correct your record
You may ask me to amend health information that you believe is incorrect or incomplete.I may deny a request in some circumstances, but I will explain the reason in writing as required by law.
Request confidential communications
You may ask me to contact you in a specific way, such as only at a particular telephone number or email address, or to send mail to a different address.I will accommodate reasonable requests.
Ask me to limit what I use or share
You may ask me not to use or disclose certain health information for treatment, payment, or health care operations. I am not always required to agree, but I will honor an agreed restriction except when disclosure is permitted or required by law, including in an emergency when appropriate.If you pay for a service out of pocket in full, you may ask me not to disclose information about that service to your health plan for payment or health care operations. I will honor that request unless a law requires the disclosure.
Get a list of certain disclosures
You may request an accounting of certain disclosures of your health information made during the six years before your request, including who received the information and why.The accounting does not include certain disclosures, such as many disclosures for treatment, payment, health care operations, or disclosures you authorized. One accounting in a 12-month period will be provided without charge; a reasonable cost-based fee may apply to additional requests.
Get a copy of this notice
You may request a paper copy of this Notice at any time, even if you agreed to receive it electronically. I will provide a copy promptly.
Choose someone to act for you
If another person is legally authorized to act for you, such as a guardian, health care agent, or other personal representative, that person may exercise your privacy rights as permitted by law.
File a complaint if you believe your privacy rights were violated
You may complain directly to me using the contact information at the end of this Notice.You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue, S.W., Washington, D.C. 20201; 1-877-696-6775; or hhs.gov/hipaa/filing-a-complaint.I will not retaliate against you for filing a complaint.
2. Your Choices
For certain health information, you may tell me your preferences about what I share. If you have a clear preference, tell me what you want me to do.Family, friends, and others involved in your care
You may tell me whether I may share relevant information with family members, close friends, or others involved in your care or payment for your care.If you are unable to tell me your preference, I may share limited information when permitted by law and when I believe it is in your best interest. I may also disclose information when necessary to prevent or lessen a serious and imminent threat to health or safety, as permitted by law.
Written authorization is generally required for certain uses and disclosures
I will obtain your written authorization before using or disclosing PHI for marketing when HIPAA requires authorization.I do not sell your PHI.Most uses and disclosures of psychotherapy notes require your written authorization, subject to limited exceptions allowed by law.I do not use your PHI for fundraising.
3. How I Typically Use and Disclose Your Health Information
Treatment
I may use your health information to provide, coordinate, or manage your care and may share information with other health care professionals involved in your treatment when permitted by law. Example: with appropriate legal authority, I may coordinate with another treating clinician about your care.Payment
I may use and disclose health information to bill for services and obtain payment from you, an insurer, or another responsible payer. Example: I may provide information required by your health plan to process a claim.Health care operations
I may use and disclose health information for activities necessary to operate the practice, improve quality, conduct compliance activities, manage records, and administer services. I may use service providers that perform functions on my behalf and require them to protect PHI as required by applicable law.4. Other Uses and Disclosures Permitted or Required by Law
HIPAA and other laws allow or require uses and disclosures in certain circumstances. I will disclose only the information permitted or required and will comply with any additional conditions imposed by Wisconsin or other applicable law.Public health and safety activities, such as certain legally required reports of abuse, neglect, or threats to health or safety.Health oversight activities authorized by law, such as audits, investigations, inspections, or licensure matters.Workers’ compensation and similar programs when authorized by law.Certain law-enforcement requests and special government functions when the legal requirements for disclosure are met.Judicial or administrative proceedings when disclosure is authorized or required by applicable law, such as in response to a valid court order or other lawful process.Coroners, medical examiners, or funeral directors when permitted by law after a person’s death.Research only when the requirements of applicable law are satisfied.Other disclosures required by federal or state law, including disclosures to the U.S. Department of Health and Human Services when necessary to determine HIPAA compliance.
5. Mental Health Records and Wisconsin Law
Mental health treatment records may receive protections under Wisconsin law that are more restrictive than HIPAA. Becomingness Therapy and Consulting LLC will follow applicable Wisconsin confidentiality requirements, including Wis. Stat. § 51.30 and related regulations, when they provide greater protection or require additional authorization before disclosure.Because these rules contain exceptions and may depend on the type of record and purpose of disclosure, not every legally permitted disclosure is listed in this Notice. When a disclosure requires your written authorization under applicable law, I will obtain it before making the disclosure.6. Substance Use Disorder Records
To the extent that I maintain records about you that are protected by 42 CFR Part 2, those records have additional federal confidentiality protections. Part 2 records generally may not be used or disclosed in civil, criminal, administrative, or legislative investigations or proceedings against you unless you provide written consent or a court order and subpoena authorize the use or disclosure as required by law.If Part 2 records are used for fundraising communications, you will receive clear notice and an opportunity to opt out as required by law. Becomingness Therapy and Consulting LLC does not currently use PHI for fundraising.7. My Responsibilities
I am required by law to maintain the privacy and security of your PHI.I will notify you as required by law if a breach occurs that may have compromised the privacy or security of your information.I must follow the duties and privacy practices described in the Notice that is currently in effect and provide you with a copy upon request.I will not use or disclose your information other than as described in this Notice unless you authorize me to do so in writing or another use or disclosure is permitted or required by law. You may revoke a written authorization at any time in writing, except to the extent I have already relied on it.
8. Changes to This Notice
I may change the terms of this Notice and may make the revised Notice effective for all PHI I maintain, including information created or received before the revision. The current Notice will be available upon request and will be posted on the practice website.9. Privacy Contact and Complaints
For questions about this Notice, to exercise a privacy right, or to make a complaint, contact:Gretchen Ekins, MSW, LCSW - Privacy Contact
Becomingness Therapy and Consulting LLC
2301 Sun Valley Dr, #102, Delafield, WI 53018
gretchen@BecomingnessTherapy.com
(262) 900-2750
This Notice is intended to describe the privacy practices of Becomingness Therapy and Consulting LLC. It is separate from the website privacy policy, which addresses information collected through the public website outside the context of treatment records and other PHI.