Privacy & Confidentiality

Limits of Confidentiality

The NAADAC/NCC AP Code of Ethics states that addiction professionals shall only reveal client identity or confidential information without client consent when a client presents a clear and imminent danger to themselves or to another person and only to emergency personnel who are directly involved in reducing the danger or threat. Counselors shall obtain supervision or consultation when unsure about the validity of an exception and shall document the recommendations.

Duty to Warn and Protect

  1. When a client discloses intentions or a plan to harm another person, the mental health professional is required to warn the intended victim and report this information to legal authorities.
  2. In cases in which the client discloses or implies a plan for suicide, the healthcare professional is required to notify legal authorities and make reasonable attempts to notify the family of the client.
  3. Abuse of Children and Vulnerable Adults. If a client states or suggests that he or she is abusing a child (or vulnerable adult) or has recently abused a child (or vulnerable adult), or a child (or vulnerable adult) is in danger of abuse, the mental health professional is required to report this information to the appropriate social service and/or legal authorities.
  4. Prenatal Exposure to Controlled Substances. Mental health care professionals are required to report admitted prenatal exposure to controlled substances that are potentially harmful.

I agree to the above limits of confidentiality and understand their meanings and ramifications.

Code of Ethics — Licensed Social Workers

The Code of Ethics of the National Association of Social Workers and the laws of the State of Arizona ensure the conversations you have with a licensed social worker are held in strict confidence. Both verbal information and written records about a client cannot be shared with another party without the client's written consent. However, there are a few exceptions when licensed social workers are legally bound to share information given in confidence under the following circumstances:

Duty to Warn and Protect

  1. When a client discloses intentions or a plan to harm another person, the mental health professional is required to warn the intended victim and report this information to legal authorities.
  2. In cases in which the client discloses or implies a plan for suicide, the healthcare professional is required to notify legal authorities and make reasonable attempts to notify the family of the client.
  3. Abuse of Children and Vulnerable Adults. If a client states or suggests that he or she is abusing a child (or vulnerable adult) or has recently abused a child (or vulnerable adult), or a child (or vulnerable adult) is in danger of abuse, the mental health professional is required to report this information to the appropriate social service and/or legal authorities.
  4. Prenatal Exposure to Controlled Substances. Mental health care professionals are required to report admitted prenatal exposure to controlled substances that are potentially harmful.

I agree to the above limits of confidentiality and understand their meanings and ramifications.

Fees

Accepted forms of payment are cash, debit, and credit card.

PROCESSING FEE FOR DEBIT and CREDIT CARDS: There is a $5.00 processing fee for debit and credit cards. Payments are processed using "Square Inc."

Availability of Services

My services do not have the capability to respond immediately to mental health emergencies. True emergencies should be directed to the community emergency services (911) or to the local hotlines:

Privacy, Confidentiality and Records

All communications and records created in the process of the "revocation services," substance use assessment, or Federal Aviation Administration "airman medical certifications" are held in the strictest confidence. However, there are numerous exceptions to confidentiality defined in the state and federal statutes. The most common of these exceptions are when there is a real or potential life-or-death emergency, when the court issues a subpoena, or when child/elder abuse or neglect is involved.

I also participate in a process where selected cases are discussed with other professional colleagues to facilitate my continued professional growth and to get you the benefit of a variety of professional experts. While no identifying information is released during the "revocation service," the dynamics of the problems and the people are discussed along with the treatment approaches and methods.

There are also numerous other circumstances when information may be released, including when disclosure is required by the Arizona Board of Behavioral Health Examiners, when a lawsuit is filed against me, to comply with worker compensation laws, to comply with the USA Patriot Act and to comply with other federal, state or local laws.

The rules and laws regarding confidentiality, privacy, and records are complex. The HIPAA NOTICE OF PRIVACY PRACTICES, included in this packet of information, details the considerations regarding confidentiality, privacy, and your records. This packet also contains information about your right to access your records and the details of the procedures to obtain them, should you choose to do so.

Periodically, the HIPAA NOTICE OF PRIVACY PRACTICES may be revised. Any changes to these privacy practices will be posted in my office, but you will not receive an individual notification of the updates. It is imperative that you read and understand the limits of privacy and confidentiality before you start treatment.

Serving All of Arizona