Hope Heals Counseling, LLC
Sharla Alsum, MA, LPC
Carolyn Newman, MA, LPC
970-541-0596
CONFIDENTIALITY POLICY
This notice describes how medical, health, and behavioral health information about you may be used and disclosed, and how you can get access to this information. Please review it carefully.
In order for psychotherapy to be effective, clients must feel free to share personal information with their therapists. For this to be possible, clients can be assured of confidentiality except under certain situations as stated below. Federal guidelines concerning the confidentiality and security of Protected Health Information are detailed in the Health Insurance Portability and Accountability Act (HIPAA). Hope Heals Counseling, LLC, Sharla Alsum, MA, LPC and Carolyn Newman, MA, LPC, agree to maintain compliance with these guidelines and to keep material shared by clients confidential. This notice tells you how we use or share information about you. It tells you about your rights. Hope Heals Counseling, LLC, Sharla Alsum, MA, LPC, and Carolyn Newman, MA, LPC, must keep information about you private. We must tell you about our privacy rules and make sure that people who work here follow the privacy rules.
This policy of confidentiality is broad and encompasses many different aspects of psychotherapy practice. Specific information shared within therapeutic contact is protected, and client records will be kept confidential and secure. In addition, the very fact that someone is a client is protected information. Such information can only be released with your specific signed consent, except in the exceptions listed below. If you give us permission, you may change your mind at any time. If a client is a minor child, rights to confidentiality must be balanced with the parents’ right to know what is happening in the course of therapy.
Exceptions to the right to confidentiality include those issues that are mandated by law or professional ethics to be disclosed, including the following:
- Health and Safety: This may include knowledge or suspicion of child abuse, neglect, domestic violence, or endangerment, as well as imminent danger of harm to self and/or others, elder abuse, or the abuse of disabled persons.
- Lawsuits or Disputes: A judge may order the release of privileged information. In legal cases, therapists are allowed to utilize confidential information to defend self. In all of these cases, information disclosed will be minimal, including only that which is necessary to satisfy legal and/or ethical mandates.
- We may tell some things about you to a family member who helps you. We can only do this when it is needed to give you good care. If you want anyone else to know about your care, you may give us permission in writing.
- Substance Abuse: We must provide extra privacy for alcohol and drug abuse records. We cannot tell anyone that you have a drug or alcohol problem, except when the law says we can.
- HIV information: We must protect clients with HIV or AIDS. We cannot tell anyone about this without your consent unless there is a possibility for harm to others. Then we have duty to warn.
- Rights of Young People: If you are 16 or older, you may get mental health treatment without your parents’ consent. If you are a 15-year-old pregnant female, you may get mental health treatment without your parent’s consent. You can decide how information about you is shared with others. Sometimes we may tell your parents limited information if it is needed for you treatment. You may get treatment for drug or alcohol abuse at any age. We cannot tell your parents about this unless you give us consent in writing.
- National Security: We may share information about you with federal agents if there is a risk to national security, or if they need information to protect the President or other important people.
- Fraud and Abuse: We may share information about you to help investigate fraud or abuse.
Your Rights to Privacy
- You may see and copy your records. We charge a fee to copy your records. We will not let you see or copy your record if we think it could hurt you or someone else.
- You may ask us to change your records if something is wrong or missing. You must tell us why you want to do this. We may say no in certain cases.
- You may ask for a list of people who received information about you.
- You may ask us not to share information about you with anyone except for treatment, payment, or health care operations. We will consider your request, but in some cases, we do not have to agree. We must keep information private from your insurance company if you request us to, and if you pay for your care in full out of pocket.
- You may ask us to contact you at a special address or phone number.
- You may have a paper copy of this Notice at any time.
Changes to This Notice
Hope Heals Counseling may change this notice at any time. You will be notified if this occurs.
I have read and understand my rights to privacy, as well as the exceptions detailed above.
Client signature______Date ______
Parent/Guardian Signature______Date______