Privacy Policy

Arizona Notice of Policies/Practices to Protect (HIPPA)

This notice describes how psychological and medical information about you may be used and disclosed and how you can get access to this information. Please read it carefully.  This notice represents your Counselor’s Policies and Practices to protect the privacy of your Health Information and is required by Federal regulation (HIPAA Notice Form)

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Protecting Your Privacy. Real World Counseling, LLC (RWC) has a firm commitment to the privacy of personal information provided by those using our services including our website. Our policy is intended to assist you in understanding how we collect, use and safeguard the personal information you provide to us and to assist you in making informed decisions when using our services. By using the Real World Counseling website, you consent to the practices described in this statement. By using the services on this site, you understand and agree to the following terms:

What Information Do We Collect? When you visit our site or use our services you may provide us with personal information you knowingly choose to disclose. If you choose to use our services, you may need to give personal information and authorization to obtain information from various credit services. For example, you may need to provide the following information: - Name - Mailing address - Credit card billing address - Email address - Credit card number - Name on credit card - Credit card billing address. You may also need to provide personal information such as date of birth, insurance member identification and home address as this information is needed in order to determine your insurance benefits.

Email Information. If you choose to correspond with us through email counseling, we will retain the content of your email messages together with your email address and our responses. We provide the same protections for these electronic communications that we employ in the maintenance of information received by mail, telephone, and in live sessions. There is no guarantee that others at the receiving end of the email will keep the information confidential. i.e. others at the receiving end may read your email.

Send Real World Counseling’s Staff e-mail.  By sending us an electronic mail message, you may be sending us personal information (e.g., name, e-mail address, etc.). We may store your name and e-mail address and other information you may send us in order to respond to your message.

How Do We Use the Information That You Provide to Us? Your personal or business identifiable information will not be shared with any outside party except as may be required by law including as needed to collect payment for services, render appropriate services to the client, and protect others who may be in harms way. Read more about this in our Arizona Notice of Policies (HIPAA).  

What About Legally Compelled Disclosure of Information? We may disclose information when legally compelled to do so. We may also disclose account information when we have reason to believe that disclosing this information is necessary to identify, contact or bring legal action against someone who may be violating our Terms of Service or to protect the safety of our users and the public.  

View or download information.  We may collect and store information for statistical purposes. For example, we may count the number of visitors to the different sections of our site to help us make them more useful to visitors. Similar information is gathered for streaming audio and video, visits to web pages that require users to log in, interactive forms or questionnaires, or for other comparable types of connections.  

Web Server Log Files.  Our web server log automatically collects each visitor's domain name.  For visitors merely browsing our site, we only collect the domain name and user-specific browsing data regarding what pages consumers access or visit.  Any information collected is used for internal review to improve the content of our web pages.

What About Other Websites Linked to Our Website?  We are not responsible for the practices employed by internet sites linked to or from our site or the information or content contained therein. Often links to other Internet sites are provided solely as pointers to information on topics that may be useful to the users of our site. Please remember that when you use a link to go from our website to another website, our Privacy Policy is no longer in effect. Your browsing and interaction on any other web site, including web sites which have a link on our website, is subject to that website's own rules and policies. Please read over those rules and policies before proceeding. By using our website you consent to our collection and use of your personal information as described in this Privacy Policy.

Our Commitment To Data Security. Please note that your information will be stored and processed on our computers. To prevent unauthorized access, maintain data accuracy, and ensure the correct use of information, we have put in place appropriate physical, electronic, and managerial procedures to safeguard and secure the information we collect online or in person.

What Are Our Limits of Liability? Real World Counseling will not be liable for any direct, indirect or consequential loss or damage arising under this disclaimer or in connection with our website, whether arising in tort, contract, or otherwise – including, without limitation, any loss of profit, contracts, business, goodwill, data, income, revenue, earnings or anticipated savings, costs of time or travel, legal fees, or fees by other providers of service as engaged by Client. Real World Counseling LLC's liability is limited to the client's out-of-pocket therapy session fees purchased by client, fulfilled by client, and paid to Real World Counseling, LLC in the most recent (30) day period of time.

Uses and Disclosures for Treatment, Payment, and Health Care Operations RWC may use or disclose your protected health information (PHI), for treatment, payment, and health care operations purposes with your consent. To help clarify the terms, here are some definitions:

Uses and Disclosures Requiring Authorization RWC may use or disclose PHI for purposes outside of treatment, payment, or health care operations when your appropriate authorization is obtained. An “authorization” is written permission above and beyond the general consent that permits only specific disclosures. In those instances when RWC is asked for information for purposes outside of treatment, payment, or health care operations, we will obtain an authorization from you before releasing the information. RWC needs to obtain an authorization before releasing your Psychotherapy Notes. “Psychotherapy Notes” are notes that the therapist may have made about our conversation during a private, group, joint, or family counseling session, which are kept separate from the rest of your medical record. These notes are given a greater degree of protection than PHI. You may revoke all such authorizations (of PHI or Psychotherapy Notes) at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) the therapist has relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, the law providing the insurer the right to contest the claim under the policy.

Uses and Disclosures with Neither Consent nor Authorization RWC may use or disclose PHI without your consent or authorization in the following circumstances:

Client’s Rights Counselor’s Duties:

Questions and Complaints If you have questions about this notice, disagree with a decision the therapist makes about access to your records, or have other concerns about your privacy rights, you may contact us in writing via registered mail to Real World Counseling, LLC, PO Box 2708, Carefree, AZ 85377-2708. We will work with you as best we can under the requirements of law, our professional standards, and this policy. 

Effective Date, Restrictions, and Changes to Private Policy The effective date of this revised notice is February 1, 2013.  Real World Counseling, LLC reserves the right to change the terms of this notice and to make new notice provisions effective for all PHI that are maintained. However, please be assured that if the Privacy Policy changes in the future, we will not use the personal information you have submitted to us under this Privacy Policy in a manner that is materially inconsistent with this Privacy Policy, without your prior consent.  

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Client Agreement Regarding Terms I have read and understand the enclosed information as it relates to my protected health information (PHI) and other matters. I have had an opportunity to ask questions, and by signing below agree to the terms and conditions of this privacy policy.  


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Client’s signature                                                         Date