LIMITS ON CONFIDENTIALITY. The law protects the privacy of all communications between a patient and a psychotherapist. In most situations, I can only release information about your treatment to others if you sign a written authorization form that meets certain legal requirements imposed by HIPAA. There are other situations that require only that you provide written, advance consent. Your signature on this Agreement provides consent for those activities, as follows: • I may occasionally find it helpful to consult other health and mental health professionals about a case. During a consultation, I make every effort to avoid revealing the identity of my patient. The other professionals are also legally bound to keep the information confidential. If you don’t object, I will not tell you about these consultations unless I feel that it is important to our work together. I will note all consultations in your Clinical Record (which is called “PHI” in my Notice of Psychotherapist’s Policies and Practices to Protect the Privacy of Your Health Information). • You should be aware that I practice with other mental health professionals and that I employ administrative staff. In most cases, I need to share protected information with these individuals for both clinical and administrative purposes, such as scheduling, billing, and quality assurance. All of the mental health professionals are bound by the same rules of confidentiality. All staff members have been given training about protecting your privacy and have agreed not to release any information outside of the practice without my permission. • I also have a contract with a billing service. As required by HIPAA, I have a formal business associate contract with this business, in which it promises to maintain the confidentiality of this data except as specifically allowed in the contract or otherwise required by law. If you wish, I can provide you the name of this organization and/or a blank copy of this contract. I also will ask for your permission before having the billing service contact you. • Disclosures required by health insurers or to collect overdue fees are discussed elsewhere in this Agreement. • If a patient threatens to harm himself/herself, I may be obligated to seek hospitalization for him/her, or to contact family members or others who can help provide protection. There are some situations where I am permitted or required to disclose information without either your consent or Authorization: • If you are involved in a court proceed...
LIMITS ON CONFIDENTIALITY. The law protects the privacy of all communications between a patient and a Psychologist. In most situations, I can only release information about your treatment to others if you sign a written Authorization form that meets certain legal requirements imposed by HIPAA. There are other situations that require only that you provide written, advance consent. Your signature on this Agreement provides consent for those activities, as follows:
LIMITS ON CONFIDENTIALITY. The law protects the privacy of all communications between a client and a psychologist. In most situations, I can only release information about your treatment to others if you sign a written Authorization form that meets certain legal requirements imposed by state law and/or HIPAA. With your signature on a proper Authorization form, I may disclose information in the following situations:
LIMITS ON CONFIDENTIALITY. The law protects the privacy of all communications between a patient and a psychologist. In most situations, I or other The Center for Cognitive Therapy and Assessment staff can only release information about your treatment to others if you sign a written authorization. However, there are a few exceptions to this rule:
LIMITS ON CONFIDENTIALITY. The law protects the privacy of all communications between you and your provider. In most situations, RCC will only release information about your treatment to others if you sign a written Authorization Form for each release. Our release forms meet certain legal requirements imposed by HIPAA. There are other situations that require only that you provide written, advanced consent. Your signature on this Agreement provides consent for those activities, as follows:
LIMITS ON CONFIDENTIALITY. The law protects the privacy of all communications between a patient and a licensed therapist. In most situations, your therapist can only release information about your treatment to others if you sign a written Authorization form that meets certain legal requirements imposed by HIPAA and/or Illinois law. However, in the following situations, no authorization is required (see Appendix B for details):
LIMITS ON CONFIDENTIALITY. The law protects the privacy of all communications between a patient and a psychologist. In most situations, I can only release information about your treatment to others if you sign a written Authorization form that meets certain legal requirements imposed by HIPAA and/or Maine law, or in some cases, if you provide oral authorization. However, in the following situations, no authorization is required:
LIMITS ON CONFIDENTIALITY. The law protects the privacy of all communications between a client and a mental health professional. In most situations, mental health professionals can only release information about your evaluation and/or treatment to others if you sign a written authorization form that meets certain legal requirements imposed by HIPAA. There are other situations that require only that you provide written, advance consent. Your signature on this Agreement provides consent for those activities as follows: o I may occasionally find it helpful to consult other health and mental health professionals about a case. During a consultation, every effort is made to avoid revealing the identity of the client. The consulted professionals also are legally bound to keep the information confidential. If you do not object, you will not be informed about these consultations unless your therapist determines that it is important to do so. All such consultations will be noted in your Clinical Record (which is called “PHI” in the Notice of Policies and Practices to Protect the Privacy of Your Health Information). o You should be aware that this practice has administrative staff. In most cases, I will need to share protected information with these individuals for both clinical and administrative purposes, such as scheduling, billing, and quality assurance. All mental health professionals are bound by the same rules of confidentiality. All staff members have received training about protecting your privacy and have agreed not to release any information outside of the practice without the permission of a mental health professional. o Disclosures required by health insurers or any other disclosure necessary to obtain reimbursement for services. This matter is discussed in more detail elsewhere in this Agreement. o If a client seriously threatens to harm himself/herself, mental health professionals may be obligated to seek hospitalization for him/her, or to contact family members or others who can help provide protection. Texas law provides that a mental health professional may disclose confidential information only to medical or law enforcement personnel if the mental health professional determines that there is a probability of imminent physical injury by the client to the client or others, or there is a probability of immediate mental or emotional injury to the client. There are some situations where mental health professionals are permitted or required to disclose client information without t...
