Privacy and Confidentiality

In order to provide you with the best possible services, all professional staff of the Counseling and Mental Health Center involved in your treatment and employees involved in the counseling operations of the agency may have access to your records.  Information may be shared among different service providers who are involved in your treatment.  For example, if you are seeing both a psychiatrist and therapist they may share information in the process of coordinating your care.  Counseling and Mental Health Center records may be reviewed as part of an on-going process directed toward assuring the quality of agency operations.

Your counseling record may include any or all of the following information:

• Intake forms and other documents you fill out
• Your counselor’s recording of the concerns and symptoms you describe, and the information provided about your personal history
• Therapy goals and treatment plan
• Records of therapy contacts and sessions, including topics discussed, therapeutic approach utilized, therapist observations, progress toward goals, and any risks that need to be addressed
• Psychological testing data and results
• Psychiatric evaluation, treatment, and follow-up information
• Documents you provide to us that we keep
• Treatment records forwarded to us by other service providers
• Records of Consultation or Information provided about you by a collateral source

Your counseling record does not include any subjective psychotherapy notes or electronic recordings used by your counselor to prepare the record or to note significant content or process from session to session.

Your Counseling and Mental Health Center record is maintained as a combination of paper and electronic documents.  Both formats are stored with a very high level of secure protection.  Your Counseling and Mental Health Services record will be retained by the Counseling and Mental Health Center for approximately seven years after your last clinical contact with the agency. After that time has elapsed, the record will be destroyed in a way that protects your privacy.

Your records may be used for the following purposes:

• Appointment reminders (unless you request otherwise in writing)
• Notification when an appointment is canceled or rescheduled by the Counseling and Mental Health Center (unless you request otherwise in writing)
• Reporting of child or elder abuse or neglect (as required by law)
• Mental health oversight activities (e.g., audits, inspections or investigations of administration and management of the Counseling and Mental Health Center)
• Lawsuits and disputes (We will attempt to provide you notice of any subpoena we receive before disclosing information from your record.)
• Law enforcement (e.g., in response to a court order or other legal process) to identify or locate an individual being sought by authorities; about victim of a crime under restricted circumstances; about a death that may be the result of criminal conduct; about criminal conduct that occurred in the Counseling and Mental Health Center; when emergency circumstances occur relating to a crime
• To prevent a serious threat to the health or safety of yourself or any other person (such disclosure may be to medical personnel, law enforcement personnel, university personnel, or to family or other appropriate individuals in order to protect you or others)
• To military command authorities if you are a member of the armed forces or a member of a foreign military authority
• National security and intelligence activities
• Protection of the President or other authorized persons for foreign heads of state, or to conduct special investigations
• As may otherwise be required by law
• Alcohol and drug abuse information has special privacy protections. The Counseling and Mental Health Center will not disclose any information identifying an individual as being a client or provide any mental health or medical information relating to a client's substance abuse treatment unless:
• the client consents in writing;
• a court order requires disclosure of the information;
• medical personnel need the information to meet a medical emergency;
• qualified personnel use the information for the purpose of conducting research, management audits, or program evaluation; or
• it is necessary to report a crime or a threat to commit a crime or to report abuse or neglect as required by law.

Your authorization is required for certain disclosures. Except as described previously, we will not use or disclose information from your record unless you authorize in writing the Counseling and Mental Health Center to do so. You may revoke your permission, which will be effective only after the date of your written revocation.

You have the following rights regarding your counseling information, provided that you make a written request to invoke the right on the form provided by the Counseling and Mental Health Center:

• Right to request restriction.
  You may request limitations on your mental health information we may disclose, but we are not required to agree to your request. If we agree, we will comply with your request unless the information is needed to provide you with emergency treatment.
• Right to confidential communications. 
  You may request communications in a certain form or at a certain location (e.g., only at home), but you must specify in writing how or where you wish to be contacted.
• Right to inspect and copy information. 
  You have the right to request to inspect and copy your counseling record; however, psychotherapy notes may not be inspected and copied. We may charge a fee for copying, mailing, and supplies. Under limited circumstances, your request may be denied. In that case, you may request review of the denial by another licensed mental health professional chosen by the Counseling and Mental Health Center. The Counseling and Mental Health Center will comply with the outcome of the review.
• Right to request that your record be amended. 
  If you believe that the information we have about you is incorrect or incomplete you may ask us to add clarifying information. We will provide a form for that purpose. The Counseling and Mental Health Center is not required to agree to the requested amendment.
• Right to accounting of disclosures. 
  You may request a list of the disclosures of your counseling information that have been made to persons or entities other than for treatment or health care operations in the last six  years. Such information may not be available for disclosures prior to April 14, 2003.
• Right to a copy of this Notice. 
  You may request a copy of this Notice at any time.

The Counseling and Mental Health Center may change its policies or procedures in regard to privacy practices. If and when changes occur, the changes will be effective for information we already have about you as well as any information we receive in the future. Any time you come in to the Counseling and Mental Health Center for an appointment, you may ask for and receive a copy of the Privacy Notice that is in effect at the time.

If you believe your privacy rights have been violated, you may file a complaint with the Counseling and Mental Health Center, or with the office of the Vice President for Student Affairs. You will not be penalized or retaliated against in any way for making a complaint.

Call the Counseling and Mental Health Center and ask to speak to the Clinical Director for the Counseling and Mental Health Center if:

• You have a complaint.
• You have any questions about this notice.
• You wish to request restrictions on uses and disclosure of counseling information.
• You wish to obtain any of the forms mentioned to exercise your individual rights described above.

• Client Handbook (PDF)
• Notice of Privacy and Confidentiality Practices (PDF)
• General Release of Information Form for printing (PDF)
• Psychiatry Informed Consent (PDF)
• Psychiatry Release of Information for Health Services (PDF)
• Instructions for General Release of Information Form - Docusign
• General Release of Information Form-Docusign
• Couples Informed Consent (PDF)
• Case Management Informed Consent (PDF)