Notice of Privacy Practices

Effective date: November 5, 2026

Adapted from the HHS Office for Civil Rights Model Notice of Privacy Practices for HIPAA Covered Health Care Providers (content last reviewed by HHS on February 13, 2026).

Who this notice applies to

This notice applies to KL Therapy Services, PLLC, including Karlie Libraro and any therapists who work with us. We are a health care provider covered by HIPAA, the federal Health Insurance Portability and Accountability Act.

In this notice, "you" means the patient. For a child, the child's parent or legal guardian can use these rights and make these choices for the child.

This notice covers the children we see through our private practice. That includes therapy at home, at a school or daycare that a family arranges and pays for, and teletherapy. It also covers children we see at a private school when the family arranges the therapy with us.

Student records under a school contract

We also serve students under contracts with school divisions and charter schools. Records about those students are generally education records under FERPA, the Family Educational Rights and Privacy Act (34 CFR Part 99). For students with an IEP, the privacy rules in the Individuals with Disabilities Education Act apply too.

HIPAA doesn't cover education records. They are left out of the definition of protected health information (45 CFR 160.103). So this notice does not apply to them. The school's own FERPA policies do, and we follow the school division's direction for those records.

To see a school record or ask for a correction, contact the school. The school holds the record and answers those requests.

The U.S. Departments of Education and Health and Human Services explain how the two laws fit together in their Joint Guidance on the Application of FERPA and HIPAA to Student Health Records (also on HHS.gov).

Your rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get a copy of your record

You can ask to see or get a paper or electronic copy of your medical record and other health information we have about you. Ask us how to do this.

We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your record

You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.

We may say "no" to your request, but we'll tell you why in writing within 60 days.

Ask for confidential communications

You can ask us to contact you in a specific way (for example, at a certain phone number or email address) or to send mail to a different address. We will say "yes" to all reasonable requests.

Ask us to limit what we use or share

You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say "no" if it could affect care. If we agree, we may still share the information if you need emergency treatment.

If you pay for a service or health care item out of pocket in full, you can ask us not to share that information with your health insurer for the purpose of payment or our operations. We will say "yes" unless a law requires us to share it.

Get a list of those with whom we've shared your information

You can ask for a list (an accounting) of the times we've shared your health information in the six years before the date you ask, who we shared it with and why.

We will include all the disclosures except those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We'll provide one accounting a year for free. We will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this notice

You can ask for a paper copy of this notice at any time, even if you agreed to receive it electronically. We will give you a paper copy promptly.

Choose someone to act for you or your child

If someone has authority to act as your personal representative, such as a medical power of attorney or a legal guardianship, that person can use your rights and make choices about your health information.

For a child, the child's parent or legal guardian is usually the personal representative. There are exceptions, for example where the law lets a minor agree to certain care without a parent. We will make sure the person has this authority before we act.

File a complaint if you feel your rights were violated

You can complain to us by using the contact information at the end of this notice.

You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. Write to 200 Independence Avenue, S.W., Washington, D.C. 20201, call 1-877-696-6775, or visit hhs.gov/hipaa/filing-a-complaint.

We will not retaliate against you for filing a complaint.

Your choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and the choice to tell us to:

• share information with your family, close friends, or others involved in your care or payment for your care
• share information in a disaster relief situation

If you are not able to tell us your preference, for example in an emergency, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

• marketing purposes
• sale of your information
• most sharing of psychotherapy notes

Our uses and disclosures

How we typically use or share your health information

Treat you

We can use your health information and share it with other professionals who are treating you.

Example: We send your child's pediatrician a progress report.

Run our practice

We can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use health information about you to manage your treatment and services.

Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities.

Example: We give information about you to your health insurance plan so it will pay for your services.

How else we can use or share your health information

We are allowed or required to share your information in other ways, usually in ways that contribute to the public good. We have to meet many conditions in the law before we can share your information for these purposes.

Help with public health and safety issues

We can share health information about you for certain situations, such as:

• reporting suspected abuse, neglect, or domestic violence
• preventing or reducing a serious threat to anyone's health or safety

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we're complying with federal privacy law.

Work with health oversight agencies

We can share health information about you with health oversight agencies for activities the law authorizes.

Respond to lawsuits and legal actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Substance use disorder records

To the extent that we have your substance use disorder patient records, subject to 42 CFR part 2, we will not share that information for investigations or legal proceedings against you without your written consent, or a court order and a subpoena.

Rare situations the law allows

These almost never apply to a speech therapy practice. The law allows us to share health information in these situations, so we list them here. We would do it only as the law allows.

• for public health activities such as preventing disease, helping with product recalls, and reporting adverse reactions to medications
• for health research
• with organ procurement organizations, for organ and tissue donation requests
• with a coroner, medical examiner, or funeral director when an individual dies
• for workers' compensation claims
• for law enforcement purposes or with a law enforcement official
• for special government functions such as military, national security, and presidential protective services

Our responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• 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. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information, see HHS's guide to privacy practices notices.

State law

Where Virginia or Illinois law gives you more protection than HIPAA, we follow it. A few rules matter most to families:

• Virginia, a parent's access. Neither parent can be denied access to their minor child's health records because of custody. The exceptions are a court order that says otherwise, or a reason the law allows, such as protecting the child or someone else from harm.
• Virginia, subpoenas. Before we respond to a subpoena for health records, we follow Virginia's notice and waiting-period rules. They give the patient time to object.
• Virginia, keeping records. For records we keep ourselves, we keep a child's record for at least six years after the last visit, or until the child turns 18, whichever is longer.
• Illinois. Illinois has its own mental health and developmental disabilities confidentiality law. Where it applies to a child's services, it can limit a parent's access to the record of a child age 12 to 17.

Our website

Please don't send health details through our website forms or by ordinary email. What the website collects is explained in our privacy policy.

Changes to this notice

We can 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 request and on our website.

Who to contact

To use any of your rights, ask a question about this notice, or file a complaint with us, contact our privacy official:

Karlie Libraro, M.S., CCC-SLP
Phone: (804) 420-2273
Email: karlie@kltherapyservices.com

You can send written requests and complaints by email. You don't need a mailing address.