Notice of Privacy Practices
LightWell Integrative Psychiatry
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.
Practice Contact for Privacy Questions
Dr. Hilary Butella
LightWell Integrative Psychiatry
25213 FM 2978, Building 3
Tomball, TX 77375
Phone: 713-999-1002
Email: info@lightwellpsychiatry.com
Website: www.lightwellpsychiatry.com
Our Duties
We are required by law to maintain the privacy of your protected health information, provide you with this notice of our
legal duties and privacy practices, and follow the terms of the notice currently in effect. We may change this notice
and make the new notice effective for all protected health information we maintain. An updated notice will be available
at our office and on our website.
How We May Use and Disclose Your Information
We may use and disclose your protected health information for treatment, payment, and health care operations.
Examples include providing psychiatric evaluation and treatment, coordinating care with other providers involved in
your treatment, submitting claims to your health plan, obtaining prior authorization, scheduling appointments,
conducting quality improvement activities, training, licensing, compliance, and other business operations permitted by
law.
Additional Situations Permitted or Required by Law
We may use or disclose your information when required by federal or Texas law, for public health activities, to report
abuse or neglect when legally required, for health oversight activities, in response to court orders or other lawful
process, for certain law enforcement purposes, to avert a serious threat to health or safety, for workers' compensation
matters, and for specialized government functions when authorized by law.
Special Protection for Mental Health Information and Psychotherapy Notes
Because this is a psychiatry practice, some information may receive added protection under federal or Texas law.
Psychotherapy notes, if maintained separately from the medical record, generally require your written authorization
for use or disclosure except in limited situations allowed by law. Texas law may also provide additional confidentiality
protections for mental health records.
Uses and Disclosures Requiring Your Written Authorization
We will obtain your written authorization for uses and disclosures not otherwise permitted or required by law. Most
uses and disclosures of psychotherapy notes require authorization. We will also obtain authorization for most uses
and disclosures of protected health information for marketing purposes and for any sale of protected health
information, unless an exception applies. You may revoke an authorization in writing at any time to the extent we
have not already acted on it.
Your Rights
You have the right to request restrictions on certain uses and disclosures, request confidential communications,
inspect and obtain a copy of your records in many circumstances, request an amendment, receive an accounting of
certain disclosures, obtain a paper copy of this notice, and choose someone to act for you where legally authorized.
Some of these rights are subject to specific legal requirements and exceptions.
Breach Notification
If a breach of unsecured protected health information occurs, we will notify you as required by law.
Complaints
If you believe your privacy rights have been violated, you may file a complaint with LightWell Integrative Psychiatry
using the contact information above or with the U.S. Department of Health and Human Services. You will not be
retaliated against for filing a complaint.
Effective Date
Effective Date: March 21, 2026