Privacy Notice

At Centennial Counseling Center we are committed to treating and using protected health information responsibly. This Notice describes the procedures we use to protect your information, and the circumstances under which your personal health information may be disclosed. It also describes your rights as they related to this information. The rules for confidentiality of mental health records are records in the Illinois Mental Health and Developmental Disabilities Confidentiality Act and in the privacy rules of the Health Insurance Portability and Accountability Act.

We strive to protect your personal health information.

At CCC, every effort is made to keep your personal health information private.  Some of our procedures will be evident to you. For example, when you call to discuss an issue with office staff, we may ask you for some piece of identifying information to confirm your identity. Others happen behind the scenes. Computer data is password protected at the work stations and encrypted if it is transferred electronically. Files are secured in locked cabinets at night, and every effort is made to prevent others from viewing your personal health information when it is being worked on by staff members during the day. If you have any concerns about your privacy, please bring them to our attention. 

You are entitled to a copy and review of your mental health records.

You have the right to inspect and/or copy your health record. If, after reviewing your record, you believe that any statement is in error, you have the right to request that the person who made the entry make a correction. Anytime you request a revision, your request and the action taken must be noted in the record.  If a professional chooses to stand by a statement with which you disagree, you have the right to add a written amendment stating why you believe the entry is in error.  Any time that section of the record is released, your amendment must be included.

The following individuals can access a mental health record without written authorization.

1) an adult recipient of services; 2) the parent or guardian of a child who is under the age of 12 years of age; 3) the recipient if he is 12 years of age or older; 4) the parent or guardian of a recipient who is at least 12 but under 18, if the recipient does not object or if the therapist does not find that there is a compelling reason for denying access, but nothing in this statement is intended to prevent a parent or guardian of a child who is at least 12 but under 18 from requesting and receiving the following information: current physical and mental condition, diagnosis, treatment needs, services provided, and services needed;  5) a legal guardian of a recipient who is 18 or over; 6) an attorney, guardian ad litem, or power of attorney or other person who is legally authorized to access the records. We are happy to provide you with assistance in understanding the record. 

In the following circumstances, we may release your records without your permission.

There are circumstances that impose limitations on a client's right or ability to maintain privileged communication. A therapist may disclose a record without consent:  1) to a supervisor, consulting therapist, or member of the staff team participating in the provision of services, a record custodian, or a person acting under the supervision of the therapist; 2) when a therapist believes a clear and immediate danger exists to one or more persons; 3) when disclosure is necessary to provide the recipient with emergency medical care or access to needed benefits when the recipient is not in a condition to waive or assert his or her rights; 4) when abuse or neglect of a child is suspected; 5) when a therapist is consulting with an employer, attorney, professional liability company, or other relevant business associate concerning the care or treatment he or she has provided, including disclosure to business associates who may help us pursue payment (but each of these recipients shall be held to HIPAA privacy standards and may not redisclose the information); 6) when a recipient introduces his or her mental condition or any aspect of services received for such condition as an element of a claim or defense; and 7) in certain other legal situations where the court has decided that disclosure is directly relevant to the issue being investigated.

Additional Rights. 

You have the right to request restrictions on certain uses and disclosure of PHI.  However, CCC is not required to agree to a requested restriction, and in some situations, is prohibited by law from agreeing to a requested restriction. You have the right to request and receive an accounting of disclosures that we make to other individuals.

CCC reserves the right to change the terms of its Privacy Policy and to make the new Policy provisions effective for all PHI that is maintains. You will be notified of any changes to the Policy.

If you believe your privacy has been violated, first bring the matter to the Office Manager of the office where you are receiving services. If you have a dispute which cannot be resolved, please contact the Privacy Officer, Dr. David Norton or his designee, at 630/377-6613. You may also file a complaint with the Office for Civil Rights, U.S. Department of Health & Human Services, 200 Independence Avenue; S.W., Room 509F, HHH Building, Washington, DC 20201. There can be no retaliation for filing a complaint.


See our Statement of Client Rights


Back To Top