Notice of Privacy Practices.

 

Notice of Privacy Practices

Montina Myers-Galloway, PLLC d/b/a Myers-Galloway Counseling · 421 South Sharon Amity Road, Suite C, 2nd Floor, Charlotte, NC 28211 · (704) 750-1889 · www.myersgallowaycounseling.com

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.

Effective date: November 4, 2026
This notice replaces our notice dated May 28, 2022.
Last updated: November 4, 2026

Your story is yours. In therapy you share things you may never have said out loud, and protecting that trust is part of the care we give you. This notice explains how we use and share your health information, the rights you have over it, and the steps we take to protect it.

This notice covers Montina Myers-Galloway, PLLC d/b/a Myers-Galloway Counseling (“MGC,” “we,” “us,” “our”) and every clinician, staff member, and contractor who works with us. It applies to all records of your care that we create or keep, whether on paper or electronically.

As a mental health provider in North Carolina, we follow two sets of rules: the federal privacy law known as HIPAA, and North Carolina’s mental health confidentiality laws, including N.C. General Statutes Chapter 122C. When North Carolina law gives you more privacy than federal law, we follow North Carolina law.

Your Rights

You have the following rights over your health information. To use any of them, contact our Privacy Officer (contact details are at the end of this notice). Where we ask for a written request, a text to our office at (704) 750-1889 or an email to privacy@myersgallowaycounseling.com counts. You don’t need to include health details in the message.

Get a copy of your record. You may look at or get a copy of your health and billing records, or a summary if you prefer. You may ask for a paper or electronic copy, and we will provide it in the format you ask for if we can readily produce it. You may also direct us to send a copy to another person or organization you name. We will respond within 30 days of your request. If we need more time, we will tell you in writing why and when to expect it, and we will take no more than 30 additional days. We may charge only a reasonable, cost-based fee for the labor of copying, supplies, and postage. We will not charge you to search for or retrieve your records, or to look at them. We will tell you the fee in advance.

Limits on access. In a few situations the law allows us to deny access, such as to psychotherapy notes or information gathered for a lawsuit. If a licensed professional believes access is reasonably likely to endanger your life or physical safety, or someone else’s, we may deny part of your request. If we do, we will explain why in writing. In most cases you can ask for a review by another licensed professional who was not involved in the original decision.

Ask us to correct your record. If you believe information in your record is wrong or incomplete, you may ask us in writing to amend it and tell us why. We will respond within 60 days. If we say no, we will explain why in writing, and you may file a statement of disagreement that we will add to your record.

Ask us to contact you privately. You may ask us to reach you a certain way or at a certain place, for example only by cell phone, or by mail to a different address. You do not have to tell us why. We will say yes to all reasonable requests.

Ask us to limit what we use or share. You may ask us not to use or share certain information for treatment, payment, or our operations, or not to share it with a family member or someone else involved in your care. We are not required to agree, and we may say no if it would affect your care. If we agree, we will keep that promise unless the information is needed to treat you in an emergency or the law requires otherwise.

Pay out of pocket and keep it from your health plan. If you pay for a service in full yourself, you may ask us not to share information about that service with your health insurer for payment or our operations. We will say yes unless a law requires us to share it.

Get a list of who we’ve shared your information with. You may ask for a list (an “accounting”) of the times we’ve shared your information in the six years before your request, who we shared it with, and why. The list will not include disclosures for treatment, payment, or operations, disclosures you authorized, and certain other disclosures the law excludes. We will provide one list a year for free. If you ask for another within 12 months, we may charge a reasonable, cost-based fee, and we will tell you the cost first so you can withdraw the request.

Get a copy of this notice. You may ask for a paper copy of this notice at any time, even if you agreed to receive it electronically.

Choose someone to act for you. If you have given someone medical power of attorney, or someone is your legal guardian, that person can use your rights and make choices about your health information. We will confirm that person has this authority before we act.

Be told about a breach. You have the right to be notified if your unsecured health information is involved in a breach.

File a complaint. If you believe your privacy rights have been violated, you may complain to us or to the U.S. Department of Health and Human Services. How to do both is at the end of this notice. We will not retaliate against you for filing a complaint, and it will not affect your care.

Your Choices

Family, friends, and others involved in your care. We will share your information with a family member, partner, friend, or anyone else you name only with your written permission. The exceptions are an emergency, when you cannot give permission and sharing is in your best interest, or when the law permits or requires it (see “Other Uses and Disclosures” below). If you are able to, we will always give you the chance to say no first. In a disaster, we may share limited information with relief organizations so your family can be told where you are and how you’re doing, unless you tell us not to.

Uses that always require your written permission. We will never do the following without your signed authorization:

  • Share most psychotherapy notes. These are a therapist’s separate, private notes about the content of your sessions, kept apart from your main record.

  • Use your information for marketing.

  • Sell your information.

Everything else not described in this notice. We will use or share your information for any purpose not described in this notice only with your written authorization. You may revoke an authorization at any time by telling us in writing. Revoking it stops future uses and disclosures. It does not undo anything we already did while the authorization was in effect. Information we share with your permission may be shared again by the person who receives it, and federal privacy law may no longer protect it.

Fundraising. We do not use your information for fundraising.

How We Use and Share Your Information

We limit what we use and share to the minimum necessary, except where the law doesn’t require that limit, such as when we share with your other treating providers. These are the everyday ways we use and share your information.

To treat you. We use your information to provide and coordinate your care. For example, your therapist may consult with a clinical supervisor or a treatment team inside our practice. With your permission, we may coordinate with your psychiatrist, primary care provider, or another clinician treating you.

To get paid. We use and share information to bill and collect payment for your care. For example, if you use insurance, we share your diagnosis, dates of service, and the type of service with your health plan so it can pay us. When your plan requires it for payment, utilization review, or an audit, we may also share parts of your treatment record, but never psychotherapy notes without your written authorization. We may also confirm your benefits before your first session. If you pay out of pocket, see “Pay out of pocket and keep it from your health plan” above. If an employee assistance program (EAP), employer, or other program pays for your sessions, we share only what that program needs for payment, such as attendance and the number of sessions, unless you authorize more.

To run our practice. We use information to operate Myers Galloway Counseling and improve your care. For example, we review records to check the quality of our services, train and supervise clinicians, and meet licensing, audit, and legal requirements.

Training and supervision. Graduate interns and associate clinicians at MGC are supervised. Their university faculty supervisors may review limited information about your care, and session recordings only with your written permission, under agreements that protect your privacy.

Through our business associates. We use outside companies to help run our practice, such as our electronic health record and client portal, telehealth platform and billing service. Before any of them can access your information, they must sign a written agreement promising to protect it and use it only for the work we hired them to do. Some of these agreements let a vendor use information that has been de-identified, meaning stripped of anything that could identify you.

Appointment reminders and service updates. We may contact you by phone, text, email, or the client portal to remind you of appointments, follow up on your care, or tell you about other services we offer that may help you. Tell us if you want reminders sent only a certain way.

Other Uses and Disclosures the Law Allows or Requires

In the situations below, we may share your information without your authorization. We share only what the law allows, only with someone authorized to receive it, and only when both federal law and North Carolina law permit it. Where North Carolina law is stricter, we follow it.

To prevent serious harm. If, in your clinician’s professional judgment, there is an imminent danger to your health or safety or someone else’s, or a likelihood that a felony or violent misdemeanor will be committed, we may share information with a person who is able to prevent or lessen the threat, which may include law enforcement. (N.C.G.S. 122C-55; 45 CFR 164.512(j))

To report abuse and neglect. North Carolina law requires us to report suspected abuse, neglect, or dependency of a child, and suspected abuse, neglect, or exploitation of a disabled adult, to the county Department of Social Services. When North Carolina law requires it, we also report certain crimes against children to local law enforcement. We share only what the report requires. (N.C.G.S. 7B-301; 108A-102; 14-318.6)

For public health and safety. We may share information with public health authorities when the law requires or allows it, for example to prevent or control disease or to report problems with medications or products.

For court and legal proceedings. We will share information in a lawsuit, hearing, or other legal proceeding only with your written authorization or when a judge orders it. A subpoena alone, without your authorization or a court order, is not enough. If we receive a subpoena, we will make reasonable efforts to tell you before we respond so you can object, unless a court orders otherwise. (N.C.G.S. 8-53.8; 122C-54)

For law enforcement. We share information with law enforcement only when North Carolina law permits it, for example under a court order, or to prevent serious harm as described above.

For health oversight. We may share information with government agencies that oversee health care, such as licensing boards, auditors, and investigators, for activities the law authorizes.

When the law requires it. We will share information when federal or North Carolina law requires it, including with the U.S. Department of Health and Human Services if it wants to confirm we are following privacy law.

After death. We may share information with a medical examiner, coroner, or funeral director as the law allows, and as North Carolina law otherwise permits. Your information stays confidential after your death.

Organ and tissue donation. We may share information with organ procurement organizations as the law allows.

Research. We will use or share your information for research only with your written authorization, or when the law allows it without one after an independent review board approves and protects your privacy.

Specialized government functions. In limited cases the law allows us to share information for military command, national security, protective services for government officials, or correctional institutions when you are in custody.

Workers’ compensation. If you have a workers’ compensation claim related to your care with us, we may share information as North Carolina workers’ compensation law requires.

Extra Protections for Sensitive Information

Psychotherapy notes. If your therapist keeps psychotherapy notes, they are stored separately from your main record and get extra protection. We will not use or share them without your written authorization, except in the limited cases federal law allows: your therapist’s own use in treating you, supervised training, defending ourselves in a legal action you bring, a compliance review by the U.S. Department of Health and Human Services, health oversight of your therapist, a medical examiner or coroner, when the law requires it, or to prevent a serious threat to health or safety.

Substance use disorder treatment records. We don’t provide substance use disorder treatment, but we may receive records from programs that do. Those records are protected by a federal law, 42 CFR Part 2, and we follow its stricter rules. Substance use disorder treatment records we receive from programs subject to 42 CFR Part 2, or testimony relaying the content of those records, will not be used or disclosed in investigations or in civil, criminal, administrative, or legislative proceedings against you unless you give written consent, or a court orders it after notice and an opportunity to be heard is provided to you or the holder of the record. A court order authorizing use or disclosure must be accompanied by a subpoena or other legal requirement compelling disclosure before the records are used or disclosed. If you give one consent for treatment, payment, and health care operations, we may use and share those records as this notice describes, except for the limits above. If we receive records under a more specific consent, we use them only as that consent allows.

Minors. If you are under 18, your parent or legal guardian generally may see your records and make decisions about your care, as HIPAA and North Carolina law allow (N.C.G.S. 114A-10; 90-21.10B). We may limit a parent’s access if a court order restricts it; if an investigator asks us not to release records because that parent is being investigated for a crime against the child or for abuse or neglect; if a licensed professional reasonably believes the child has been or may be abused or endangered by that person, or that access is reasonably likely to cause substantial harm; or when the law otherwise prohibits it. Psychotherapy notes are not available to parents. We’ll talk with you and your parent or guardian about how confidentiality works at the start of care. Once you turn 18, you control your records.

Group sessions, intensives, and retreats. In group settings, other participants will learn some information about you. We ask every participant to keep what they see and hear confidential, but we cannot guarantee that other participants will do so. Your clinical records from these services are protected the same way as your individual records.

Email, text, tele-health, and technology. We use secure, HIPAA-compliant systems for our records, client portal, and tele-health sessions. Our office phone and text line is HIPAA-compliant too. Still, once a text or email reaches your phone or inbox, it isn’t fully secure. If you ask us to communicate by unencrypted email or text, we will explain the risks, and if you still want it, we will honor your choice. Calls to our office may be recorded for quality and training, and recordings are stored securely. We will ask for your permission before using any tool that records or transcribes your sessions, and we’ll tell you how long anything it creates is kept.

Services in other states. If you receive telehealth services while you’re located in another state, that state’s privacy and reporting laws may also apply.

Our Responsibilities

  • We are required by law to keep your health information private and secure.

  • We must give you this notice of our legal duties and privacy practices, and follow the notice currently in effect.

  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

  • We will not use or share your information other than as described here unless you tell us we can in writing.

Changes to This Notice

We may change this notice, and the changes will apply to all information we have about you, including information we created before the change. If we make a material change, the new notice will show its new effective date. It will be available on request, posted in our office, and posted on our website.

Questions and Complaints

Our Privacy Officer: Montina Myers-Galloway, LCMHC, Privacy Officer, Montina Myers-Galloway, PLLC d/b/a Myers-Galloway Counseling, 421 South Sharon Amity Road, Suite C, 2nd Floor, Charlotte, NC 28211 · (704) 750-1889 · privacy@myersgallowaycounseling.com

You may bring a question or complaint to us by phone, by email, in writing, or in person.

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 · www.hhs.gov/hipaa/filing-a-complaint

We will not retaliate against you for filing a complaint.