Common use of Clinical Record Clause in Contracts

Clinical Record. As a psychologist, I maintain confidentiality in creating, storing, accessing, transferring, and disposing of records in any medium. Your Clinical Record includes your reasons for seeking therapy, how your life is being impacted, your diagnosis, the goals that we have set for treatment, your progress toward those goals, your medical and social history, your treatment history, any past treatment records that I receive from other providers, reports of any professional consultations, your billing records, and any reports that have been sent to anyone, including reports to your insurance carrier. By submitting a written request, you may examine and/or receive a copy of your Clinical Record, except in circumstances where disclosure would be injurious to you or would constitute an immediate and grave detriment to your treatment. In such circumstances, I may provide you with an accurate and representative summary of your Clinical Record, if requested. Professional records can be very confusing and/or upsetting to an untrained reader. For this reason, I recommend that you review them in my presence or with another mental health professional. In most circumstances, I will charge a copying/printing fee of $15 plus 50¢ per page plus any postage. If you wish to review your Clinical Record, please address your request to me, so that we can discuss the best way to make this happen. In addition to your Clinical Record, I also may keep a set of Psychotherapy Notes for my own use. Psychotherapy Notes vary from client to client, but they may include the contents of our conversations, as well as sensitive information that is not required to be included in your Clinical Record. While insurance companies can request and receive a copy of your Clinical Record, they cannot receive a copy of your Psychotherapy Notes without your written AUTHORIZATION. Insurance companies also cannot require such an AUTHORIZATION as a condition of coverage nor penalize you in any way for your refusal. You may request to examine and/or receive a copy of your Psychotherapy Notes unless I determine that such disclosure would be injurious to you. All records and notes are kept double-locked or password protected, and all records are retained for a minimum of seven years as required by law. In the event of your death, the privilege to access your record passes to your estate. In the event of my own incapacitation, withdrawal, or death, another licensed psychologist will assume responsibility for my records. Currently, my records custodian is ▇▇. ▇▇▇ ▇▇▇▇▇▇▇▇.

Clinical Record. As a psychologist, I We maintain confidentiality in creating, storing, accessing, transferring, and disposing of records in any medium. Your Clinical Record includes your reasons reason for seeking therapyservices, how your life is being impacted, your diagnosis, the goals that we have set for of treatment, your progress toward those said goals, your medical and social history, your treatment history, any past treatment records that I receive received from other providers, reports of any professional consultations, your billing records, and any reports that have been sent to anyone, including reports to your insurance carrier. By submitting a written request, you may examine and/or receive a copy of your Clinical Record, except in circumstances where disclosure would be injurious to you or would constitute an immediate and grave detriment to your treatment. In such circumstances, I we may provide you with an accurate and representative summary of your Clinical Record, if requested. Professional records can be very confusing and/or upsetting to an untrained reader. For this reason, I we recommend that you review them in my the presence of your provider or with another mental health professional. In most circumstances, I we will charge a copying/printing fee of $15 plus 50¢ 1.00 per page plus any postage. If you wish to review your Clinical Record, please address your request to me, so that we can discuss the best way to make this happenyour provider. In addition to your Clinical Record, I each provider may also may keep a set of Psychotherapy Notes for my their own use. Psychotherapy Notes vary from client patient to clientpatient, but they may include the contents of our conversations, as well as sensitive information that is not required to be included in your Clinical Record. While insurance companies can request and receive a copy of your Clinical Record, they cannot receive a copy of your Psychotherapy Notes without your written AUTHORIZATION. Insurance companies also cannot require such an AUTHORIZATION as a condition of coverage nor penalize you in any way for your refusal. You may request to examine and/or receive a copy of your Psychotherapy Notes unless I we determine that such disclosure would be injurious to you. All records and notes are kept double-locked For minors under the age of 14, the consent of a parent or password protectedlegal guardian is needed for treatment, and all records are retained the law may allow parents to examine their child’s Clinical Record. However, minors 14 years or older have a right, without parental consent, to outpatient diagnosis and treatment for a minimum of seven years as required by lawmental or emotional disorders. In the event of your deaththis case, the privilege law requires that the psychologist/therapist shall have the parents involved by the end of treatment unless (1) The parents refuse to be involved, (2) The minor has been sexually abused by a parent, (3) The minor is emancipated or has been self-sustaining for 90 days, or (4) There are clear clinical indications that the parents should not be involved, in accordance with the best interest of the patient. In addition, the psychologist/therapist can disclose to a parent without the minor’s consent if disclosure is clinically appropriate and will serve the best interest of the patient due to a deterioration of condition. Because privacy in treatment is often crucial to successful progress, particularly with teenagers, we may request that parents agree not to access your record passes the child’s records, with the understanding that we will provide them with general information about their child’s attendance and progress. We will also provide parents with either a verbal or written summary of their child’s treatment when it is complete, if requested. Any other disclosures will require the child’s permission, unless we feel that the child may be in danger or may be a danger to your estateothers, in which case, we will notify the parents of our concern. In Before giving parents any information, we will discuss the event of my own incapacitationmatter with the child, withdrawalif possible, or death, another licensed psychologist will assume responsibility for my records. Currently, my records custodian is ▇▇. ▇▇▇ ▇▇▇▇▇▇▇▇to do our best to handle any objections he/she may have.