Privacy Policy

The law protects the privacy of all communications between a patient and a clinician. In most situations, I can only release information about your treatment to others if a written authorization form that meets certain legal requirements imposed by HIPAA has been signed. 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 (PHI).
• All mental health professionals are bound by the rules of HIPAA. 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.
• Disclosures required by health insurers or to collect overdue fees are discussed elsewhere in this agreement. 
• 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 proceeding and a request is made for information concerning your diagnosis and treatment, such information is protected by the clinician-patient privilege law. I cannot provide any information without your (or your legal representative’s) written authorization or a court order. If you are involved in or contemplating litigation, you should consult with your attorney to determine whether a court would be likely to order me to disclose information.
• If a government agency such as Medicare is requesting the information for health oversight activities, within its appropriate legal authority, I may be required to provide it for them.
• If a patient files a complaint or lawsuit against me, I may disclose relevant information regarding that patient as part of my defense.
• If a patient files a worker’s compensation claim, and I am providing necessary treatment related to that claim, I must, upon appropriate request, submit treatment reports to the appropriate parties, including the patient’s employer, the insurance carrier or an authorized qualified rehabilitation provider.

There are some situations in which I am legally obligated to take actions, which I believe are necessary to attempt to protect others from harm and I may have to reveal some information about a patient’s treatment. These situations are unusual in my practice.

• If I know, or have reason to suspect, that a child under 18 is abused, abandoned, or neglected by a parent, legal custodian, caregiver, or any other person responsible for the child’s welfare, Florida law requires that I file a report with the Department of Child and Family Services. Once such a report is filed, I may be required to provide additional information.
• If I know or have reasonable cause to suspect, that an elderly person or handicapped adult has been or is being abused, neglected, or exploited, Florida law requires that I file a report with the central abuse hotline. Once such a report is filed, I may be required to provide additional information.
• Florida law holds that a clinician who knows or suspects that a patient may hurt or kill him/herself or someone else may notify the appropriate authorities and the individual(s) (and close family members) concerned but is not legally obligated to do so. (The psychologist is legally obligated to conduct an evaluation of suicidal and homicidal intent in these cases.) The clinician may also initiate proceedings for involuntary examination and hospitalization (the Baker Act) but is not legally obligated to do so.

If such a situation arises, I will make every effort to fully discuss it with you before taking any action and I will limit my disclosure to what is necessary.

While this written summary of exceptions to confidentiality should prove helpful in informing you about potential problems, it is important that we discuss any questions or concerns that you may have now or in the future. The laws governing confidentiality can be quite complex, and I am not an attorney. In situations where specific advice is required, formal legal advice may be needed. 

The laws and standards of my profession require that I keep Protected Health Information about you in your Clinical Record. Except in unusual circumstances where disclosure would physically endanger you and/or others or makes reference to another person (other than a health care provider) and I believe that access is reasonably likely to cause substantial harm to such other person, you may examine and/or receive a copy of your Clinical Record, if you request it in writing. Because these are professional records, they can be misinterpreted and/or upsetting to untrained readers. For this reason, I recommend that you initially review them in my presence during a scheduled session or have them forwarded to another mental health professional so you can discuss the contents.

HIPAA provides you with several new or expanded rights with regard to your Clinical Records and disclosures of protected health information. These rights include requesting that I amend your record; requesting restrictions on what information from your Clinical Records is disclosed to others; requesting an accounting of most disclosures of protected health information that you have neither consented to nor authorized; determining the location to which protected information disclosures are sent; having any complaints you make about my policies and procedures recorded in your records; and the right to a paper copy of this agreement, the attached Notice form, and my privacy policies and procedures. I am happy to discuss any of these rights with you.