This Notice describes how medical and other protected health information may be used and disclosed and how you may obtain access to that information. Please review it carefully.

As outlined in the Advisement Form provided in connection with a court-ordered child custody evaluation, adoption evaluation, or other forensic service, these services are not confidential in the same manner as psychotherapy or other treatment services.

Information obtained during an evaluation may include Protected Health Information (“PHI”). PHI includes information that may identify you and relates to your past, present, or future physical or mental health or health care services.

Information obtained during a court-related evaluation may be summarized or referenced in an evaluation report and may be disclosed or produced to the court, attorneys of record, parties who are self-represented, or other individuals or entities as authorized by law, court order, or a valid authorization.

This Notice of Privacy Practices describes how Kristen Persilver, LPC, and, when applicable, individuals working on her behalf may use and disclose PHI in accordance with applicable federal and state law, including the Health Insurance Portability and Accountability Act (“HIPAA”), as well as applicable professional and licensing requirements.

Information regarding professional counselor licensure and applicable regulations is available through the Texas Behavioral Health Executive Council.

Kristen Persilver, LPC, takes reasonable measures to protect PHI and is required to comply with applicable privacy laws and professional requirements. This Notice may be revised when necessary to reflect changes in law, professional requirements, or practice procedures. The current version of this Notice will be available on this website.

During a child custody evaluation, adoption evaluation, or other court-related evaluation, PHI belonging to you and/or your child or children may be obtained as part of the evaluation process in accordance with the applicable court order, standards of practice, and Texas law.

This information may be considered as part of the evaluator's assessment and may be summarized, referenced, or otherwise incorporated into the evaluator's work product when relevant to the purpose and scope of the evaluation.

Information obtained during the evaluation may also be disclosed to the court, attorneys of record, self-represented parties, or others when authorized or required by the court order, applicable law, signed releases, or other lawful authority. Information may also be discussed in testimony when legally required or appropriate.

Information relevant to the evaluation may be discussed in professional consultation or peer consultation consistent with applicable ethical, legal, and professional requirements.

Court-related forensic evaluations are distinct from psychotherapy or treatment. Information obtained as part of a forensic evaluation should therefore not be assumed to be confidential or privileged.

Certain records or information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding may also be subject to exceptions under federal law, including 45 C.F.R. § 164.524(a)(1)(ii). Judicial and administrative disclosures may additionally be governed by 45 C.F.R. § 164.512(e).

When records have been obtained from another health care provider, agency, school, or other third party, the evaluator generally does not alter the contents of those records. Requests to correct information contained in records created by another provider or entity should ordinarily be directed to the original creator of the record.

Kristen Persilver, LPC, may use or disclose PHI when required or permitted by applicable federal or state law, a valid court order, subpoena, or other lawful process.

She may also be required to provide information to governmental or regulatory authorities authorized to investigate compliance with applicable privacy laws.

Because forensic evaluations are conducted for legal purposes, access to certain evaluation materials may be governed by the court order, applicable law, rules governing forensic records, and other legal requirements.

Applicable law and professional standards may permit or require disclosure of PHI without your authorization in certain circumstances, including:

1. Abuse or Neglect
Information may be disclosed to an appropriate state or local agency when required by law to report suspected abuse, neglect, or exploitation of a child, elderly person, disabled person, or other protected or vulnerable individual.

2. Judicial and Administrative Proceedings
PHI may be disclosed pursuant to a court order, subpoena, administrative order, or other lawful judicial or administrative process.

3. Law Enforcement
PHI may be disclosed to law enforcement when required or permitted by law, including in response to certain court orders, subpoenas, warrants, or other lawful processes.

4. Serious Threats to Health or Safety
Information may be disclosed when permitted or required by law to prevent or lessen a serious and imminent threat to the health or safety of an individual or the public. When appropriate, information may be disclosed to a person reasonably able to prevent or lessen the threat.

5. Public Health Activities
PHI may be disclosed to an authorized public health authority when required or permitted by law for purposes such as preventing or controlling disease, injury, or disability.

6. Medical Emergencies
Information may be disclosed to appropriate medical or emergency personnel when necessary and permitted by law to address an emergency or prevent serious harm.

7. Deceased Individuals
PHI concerning a deceased individual may be disclosed when required or permitted by applicable law, including to an authorized personal representative or other legally authorized individual.

8. Business and Administrative Operations
PHI may be used or disclosed when reasonably necessary for lawful business and administrative functions associated with the practice. When third-party service providers have access to PHI, appropriate safeguards and agreements will be used when required by law.

Uses or disclosures of PHI that are not otherwise permitted or required by law will generally be made only with written authorization.

A written authorization may generally be revoked in writing, except to the extent that action has already been taken in reliance upon the authorization or when disclosure is otherwise authorized or required by law or court order.

Because authorizations in forensic evaluations can have legal implications, individuals with questions about whether to authorize the release of information may be encouraged to consult with their attorney.

PHI will not be disclosed for research purposes unless legally permissible and any required authorization or approval has been obtained.

PHI will not be used or disclosed for fundraising purposes.

During a court-related evaluation, the evaluator may obtain information from household members, collateral sources, references, or other individuals when relevant to the evaluation and permitted by the court order, applicable law, professional standards, or appropriate authorization.

The evaluator determines whether communication with a collateral source is appropriate and what information, if any, may be disclosed during that communication.

HIPAA requires certain notices regarding uses and disclosures commonly associated with health care treatment. Court-related forensic evaluations are not psychotherapy and are not conducted for the purpose of providing mental health treatment.

PHI may ordinarily be used or disclosed by health care professionals for purposes of providing, coordinating, or managing treatment.

Court-related forensic evaluations conducted by Kristen Persilver, LPC, are evaluative rather than therapeutic. Participation in an evaluation does not establish a therapist-client treatment relationship with the evaluator.

Health care providers may ordinarily use PHI for insurance billing and other payment-related activities.

Forensic evaluation services are not billed to health insurance. Fees and payment requirements for an evaluation are governed by the applicable fee agreement, court order, and practice policies.

Individuals participating in an evaluation may also be responsible for fees charged by third parties for producing records requested as part of the evaluation.

Health care providers may ordinarily use PHI for certain administrative and health care operations.

Forensic evaluation records are handled according to the legal, ethical, professional, and administrative requirements applicable to the evaluator's forensic practice.

When contractors, consultants, administrative personnel, or other individuals have legitimate access to protected information, appropriate confidentiality and privacy safeguards are used as required by law.

Your rights concerning PHI may vary depending upon the nature of the records, the court order, applicable federal or state law, and whether information was compiled for use in a legal proceeding.

Requests concerning records or PHI should be submitted to Kristen Persilver, LPC, in writing.

You may have the right to request access to certain PHI maintained about you, subject to limitations and exceptions established by federal or state law, court order, and laws applicable to information compiled for legal proceedings.

Court-related evaluation records may be subject to different access rules than ordinary treatment records.

Reasonable, legally permissible fees may apply when copies of records are requested.

You may have the right to request an amendment to certain PHI maintained by the evaluator.

The evaluator is not necessarily required to agree to the requested amendment.

If the information at issue was created by another provider, agency, or third party and provided to the evaluator during the evaluation, a request for correction should generally be directed to the person or entity that originally created the information.

You may have the right to request an accounting of certain disclosures of your PHI, subject to exceptions established by law.

Disclosures made as part of a court-related evaluation may also be governed by the court order, Advisement Form, signed authorizations, applicable law, and the nature of the forensic proceeding.

You may request restrictions on certain uses or disclosures of PHI. The evaluator is not required to agree to every requested restriction.

Additionally, restrictions cannot prevent disclosures that are required by law or court order.

A requested restriction that prevents the evaluator from obtaining information necessary to conduct a legally or professionally adequate evaluation may affect the evaluator's ability to complete the evaluation and may be addressed as appropriate with the court and/or attorneys.

If a breach of unsecured PHI occurs and notification is required by applicable law, affected individuals will be notified in accordance with legal requirements.

You have the right to obtain a copy of this Notice of Privacy Practices. The current version is available on this website.

You may request that communications concerning PHI be made through a particular method or at a particular location when applicable and reasonable.

During a forensic evaluation, you will be asked to provide appropriate contact information, such as a telephone number and email address, for administrative and evaluation-related communication.

Because information acquired during a court-related forensic evaluation may ultimately be disclosed as part of the legal proceeding, communications with the evaluator should not be assumed to have the same confidentiality protections as communications occurring within a psychotherapy relationship.

Reasonable administrative, physical, and technological safeguards are used to protect information maintained in connection with forensic evaluations.

Evaluation-related information may be maintained in paper and/or electronic form and may be stored or transmitted using computers, mobile devices, electronic record systems, email systems, cloud-based services, or other technologies reasonably necessary to conduct the evaluation.

Reasonable security measures are used to protect electronically maintained information.

If you choose to communicate with the evaluator by email, text message, mail, electronic document transmission, or another form of electronic communication, you acknowledge that no method of electronic communication can be guaranteed to be completely secure.

Reasonable efforts are made to safeguard confidential and protected information consistent with applicable legal and professional requirements.

A forensic evaluation is conducted for a legal purpose and is not psychotherapy.

The evaluation process may involve the acquisition and review of PHI created by other health care providers or entities. Records and information obtained during the evaluation may become part of the evaluator's forensic file.

Because the evaluation is being conducted in connection with a legal proceeding, information obtained during the evaluation may be disclosed to the court, attorneys of record, self-represented parties, or other authorized individuals as permitted or required by the court order, applicable law, professional standards, signed authorizations, or other lawful authority.

Individuals participating in an evaluation should therefore understand that information provided to or obtained by the evaluator cannot be promised confidentiality from the court or the legal process.

Requests for records containing PHI should be made in writing.

If you are represented by an attorney: Your attorney may submit an appropriate written request regarding records associated with your evaluation.

If you are representing yourself: You may submit an appropriate written request directly to the evaluator.

The ability to release particular records, the timing of any release, and the individuals or entities to whom records may be provided remain subject to applicable law, court order, professional requirements, and any applicable limitations on forensic records.

If you believe your privacy rights have been violated, you may submit a written complaint to:

1801 Congress Avenue, Suite 7.300, Austin, Texas 78701
Enforcement@bhec.texas.gov
1-800-821-3205 

You may also have the right to submit a complaint to the U.S. Department of Health and Human Services Office for Civil Rights.

Professional counselors in Texas are regulated by the Texas Behavioral Health Executive Council (BHEC). Information regarding professional licensing, verification, and the complaint process is available through BHEC.

You will not be retaliated against for filing a privacy complaint in good faith.

Questions regarding this Notice of Privacy Practices or requests concerning PHI may be directed to:

Kristen Persilver, LPC
Kristen Persilver Forensics
contact@kristenpersilver.com
430-236-2552
409 E. Tyler St. Box 164

Athens, TX 75751

Effective Date: September 1, 2026