Notice of Privacy Practices

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.

We are required by law to maintain the privacy of your healthcare information and to provide you with a notice of our privacy practices.  We are required to abide by the terms of the notice that is currently in effect.  We reserve the right to change our privacy practices at any time.  If our privacy practices change, we will post a revised notice on our website and at each of our offices.  We will also provide you with a paper copy of a revised notice at your request.


Our Use of Your Health Care Information

We may use your information for treatment, payment, and health care operations.  For example:

• For treatment purposes:  We may use your information to coordinate your care with providers within Counseling Services of Dothan and with your permission, to coordinate your care and referrals to another health care provider.  For those clients receiving crisis services, we may also share information with those hospitals within which CSD provides crisis services as needed to coordinate and evaluate your care.

• For payment purposes:  We may submit portions of your information to MaineCare/Medicaid, Medicare, your insurance carrier, or other third-party payor.

• For health care operations purposes:  We may use your information in the course of quality assurance, evaluation, training, or audit activities.

We may disclose information without your authorization as permitted or required by applicable law, including for any of the following purposes:  to comply with public health statutes and rules; to make any required reports of abuse or neglect; to take steps to protect you or to warn others if your clinician/psychiatrist determines that you pose a imminent risk of serious harm to yourself or another or an emergency situation exists regarding your health or safety; to comply with health oversight activities by the Department of Health and Human Services as required by funding contracts; to comply with a court order, government subpoena, or other lawful process; for law enforcement purposes in an emergency; for research purposes; in the event of your death, to a medical examiner or funeral director as necessary; to avert a serious threat to health or safety; to government agencies, as required for national security or other specialized government functions; for workers’ compensation purposes; or to family or a direct care provider if ordered by the Commissioner of the Department of Health and Human Services or his/her designee in compliance with applicable rules.

We may use your information to contact you for appointment reminders or to provide information about treatment alternatives or other health services.  Except as described above, we will not use or disclose your information, except with your written authorization.


Your Rights

You have the right to request restrictions on the use and disclosure of your information.  However, we are not required to agree to a requested restriction, and it is our policy not to agree to such restrictions unless we determine, in our sole discretion, that a compelling reason exists to do so.  You have the right to receive communications from us in a confidential manner.  If you would like us to use another address or telephone number to contact you, you must so request in writing.

You have the right to see and receive a copy of the information in your record unless your clinician/psychiatrist determines that doing so would create imminent danger to your physical or mental well being.  In that case, our CEO or designee will review your file and if s/he agrees, then we may refuse to allow you access to your record.  In accordance with the Florida Rights of Recipients of Mental Health Services, record reviews will normally occur under the supervision of a clinician or supervisor.  If you request a copy of your record, there may be a charge for the actual cost of copying.

You have the right to decide to allow the release of your record to other treatment providers or others.  If you wish to do so, you must complete a written release of information form.  There may be a charge for the actual cost of copying. 

You have the right to receive an accounting of our disclosures of your health care information.  To receive such an accounting, please contact the Chief Privacy Officer identified below.

You have the right to amend your health care information.  If you wish to do so, please submit the proposed amendment in writing to the Chief Privacy Officer identified below.

You have the right to a paper copy of this Notice of Privacy Practices upon request. You have the right to complain to us and to the Secretary of the U.S. Department of Health and Human Services if you believe your privacy rights have been violated.  To file a complaint with us, please contact the Chief Privacy Officer as set forth in this notice.  Nobody is permitted to retaliate against you for filing a complaint.

CSD will retain your records for at least six years after you have completed your care with us.  After that time, records will be confidentially destroyed. 

For further information about our privacy policies, please contact:


April Johnson
Counseling Services of Dothan
1450 Ross Clark Circle
Telephone: 334.794.2113
FAX: 334.702.1220


Web Site Disclaimer

All materials posted on this site are subject to copyrights owned by Counseling Services of Dothan. or other individuals or entities. Any reproduction, retransmission, or republication of all or part of any document found on this site is expressly prohibited, unless Counseling Services of Dothan or the copyright owner of the material has expressly granted its prior written consent to so reproduce, retransmit or republish the material. All other rights reserved.

The names, trademarks, service marks and logos of Counseling Services of Dothan appearing on this site may not be used in any advertising or publicity, or otherwise to indicate the organization’s sponsorship of or affiliation with any product or service, with the organization's prior express written permission.

Although this Web site features links to other sites, Counseling Services of Dothan takes no responsibility for the content or information contained on those sites, as we do not exercise editorial or other control over these sites.

This Web site provides information and services in furtherance of our mission. We make no representations about the suitability or accuracy of the information on this site for any purpose.

If you see any objectionable, inaccurate or improperly functioning content or features on this site, please Tom Pooser as soon as possible.


Online Privacy Policy

Counseling Services of Dothan respects the privacy of visitors to its Web site. We strongly believe that if electronic commerce and online activities are to flourish, consumers must be assured that information provided online is used responsibly and appropriately. To protect online privacy, the organization has implemented the following policy.

About the Information We Collect - Most of the data and information we collect through our Web site is used only to help us achieve our mission. It is our policy to collect and store only personal information that our clients knowingly provide.

From Casual Web Site Visitors and General Users. We do not collect any personal information from users browsing our Web site. When you use the public areas of our Web site you are doing so anonymously. We do collect aggregate use information, such as the number of hits (visits) per page. We use aggregate data for internal and marketing purposes, but we don’t collect any personally identifying information.

From Our Clients, Donors and Other Customers. We do not asked users to provide directly via the CSD Web site.

Client/User Lists - Our client list is not for sale. When you visit our Web site or become a client, your name and mailing information will not be sold to a commercial organization.