Privacy Policy

Confidentiality & Privacy Policy

The law protects the relationship between a client and a counselor, and information cannot be disclosed without written permission.
Exceptions include:

  • Suspected child abuse or dependant adult or elder abuse, for which I am required by law to report this to the appropriate authorities immediately.
  • If a client intends to harm himself or herself, I will make every effort to enlist their cooperation in ensuring their safety. If they do not cooperate, I will take further measures without their permission that are provided to me by law in order to ensure their safety


I. Uses and Disclosures for Treatment, Payment, and Health Care Operations
I may use or disclose the protected health information (PHI), of you or your child for treatment, payment, and health care operations purposes with your consent. To help clarify these terms, here are some definitions:

  • PHI refers to information in your health record that could identify you or your child.
  • Treatment, Payment and Health Care Operations
  • Treatment is when I provide, coordinate or manage the health care of you or your child and other services related to the health care of you or your child. An example of treatment would be when I consult with another health care provider, such as your family physician or another psychologist.
  • Payment is when I obtain reimbursement for the healthcare of you or your child. Examples of payment are when I disclose the PHI of you or your child to your health insurer to obtain reimbursement for that care or to determine eligibility or coverage. Health Care Operations are activities that relate to the performance and operation of my practice. Examples of health care operations are quality assessment and improvement activities, business-related matters such as audits and administrative services, and case management and care coordination.
  • Use applies only to activities within my office such as sharing, employing, applying, utilizing, examining, and analyzing information that identifies you or your child.
  • Disclosure applies to activities outside of my office, such as releasing, transferring, or Providing access to information about you or your child to other parties.

II. Uses and Disclosures Requiring Authorization

  • I may use or disclose PHI for purposes outside of treatment, payment, and health care operations when your appropriate authorization is obtained. An authorization is written permission above and beyond the general consent that permits only specific disclosures. In those instances when I am asked for information for purposes outside of treatment, payment and health care operations, I will obtain an authorization from you before releasing this information. I will also need to obtain an authorization before releasing your or your child’s psychotherapy notes. Psychotherapy notes are notes I have made about conversations with you or your child during a private, group, joint, or family counseling session, which I have kept separate from the rest of the medical record. These notes are given a greater degree of protection than PHI. You may revoke all such authorizations (of PHI or psychotherapy notes) at any time, provided each revocation is in writing. You may not revoke an authorization to the extent that (1) I have relied on that authorization; or (2) if the authorization was obtained as a condition of obtaining insurance coverage, and the law provides the insurer the right to contest the claim under the policy.

III. Uses and Disclosures with Neither Consent nor Authorization
I may use or disclose PHI without your consent or authorization in the following circumstances:

  • Child Abuse: If I know, or have reasonable cause to suspect, that a child is abused, abandoned, or neglected by a parent, legal custodian, caregiver or other person responsible for the child’s welfare, the law requires that I report such knowledge or suspicion to the Florida Department of Child and Family Services.
  • Adult and Domestic Abuse: If I know, or have reasonable cause to suspect, that a vulnerable adult (disabled or elderly) has been or is being abused, neglected, or exploited, I am required by law to immediately report such knowledge or suspicion to the Central Abuse Hotline.
  • Health Oversight: If a complaint is filed against me with the Florida Department of Health on behalf of the Board of Psychology, the Department has the authority to subpoena confidential mental health information from me relevant to that complaint.
  • Judicial or Administrative Proceedings: If you are involved in a court proceeding and a request is made for information about you or your childís diagnosis or treatment and the records thereof, such information is privileged under state law, and I will not release information without the written authorization of you or your legal representative, or a subpoena of which you have been properly notified and you have failed to inform me that you are opposing the subpoena or a court order. The privilege does not apply when you are being evaluated for a third party or where the evaluation is court ordered. You will be informed in advance if this is the case.
  • Serious Threat to Health or Safety: When you or your child present a clear and immediate probability of physical harm to yourself (or in the case of your child, to himself/herself), to other individuals, or to society, I may communicate relevant information concerning this to the potential victim, appropriate family member, or law enforcement or other appropriate authorities.
  • Worker's Compensation: If you file a worker’s compensation claim, I must, upon request of your employer, the insurance carrier, an authorized qualified rehabilitation provider, or the attorney for the employer or insurance carrier, furnish your relevant records to those persons.
  • There may be additional disclosures of PHI that I am required or permitted by law to make without your consent or authorization, however the disclosures listed above are the most common.

IV. Patient’s Rights and Psychologist’s Duties

Patient's Rights:

  • Right to Request Restrictions -You have the right to request restrictions on certain uses and disclosures of protected health information about you or your child. However, I am not required to agree to a restriction you request.
  • Right to Receive Confidential Communications by Alternative Means and at Alternative Locations -You have the right to request and receive confidential communications of PHI by alternative means and at alternative locations.
  • Right to Inspect and Copy - You have the right to inspect or obtain a copy (or both) of PHI in my mental health and billing records used to make decisions about you or your child for as long as the PHI is maintained in the record. On your request, I will discuss with you the details of the request process.
  • Right to Amend -You hav