Client Record Rights

Your Rights
You may ask us to restrict the use and disclosure of certain information in your record that otherwise would be allowed for treatment, payment, or health care operations.  However, we do not have to agree to these restrictions.

If you believe information in your record is inaccurate or incomplete, you may request an amendment of the information.  You must submit  sufficient information to support  your request for an amendment.  Your request must be in writing.

You have a right to:
  • Receive confidential communication from us.  For example, if you want to receive bills and other information at an alternate address, please notify us.
  • Inspect the information in your records, and may obtain a copy of it. This may be subject to certain limitations and fees.  Your request must be in writing
  • Request  an accounting of certain disclosures made by us.
  • Complain to us about our privacy practices (including the actions of our staff with respect to the privacy of your health information).  You have the right to complain to the Secretary of the Department of Health and Human Services about our privacy practices.  You will not face retaliation from us for making complaints.

Except as described in the Notice, we may not make any use or disclosure of information from your record unless you give your written authorization.  You may revoke an authorization in writing at any time, but this will not affect any use or disclosure made by us before the revocation.  In addition, if the authorization was obtained as a condition of obtaining insurance coverage, the insurer may have the right to contest the policy or a claim under the policy even if your revoke the authorization.

We are Required to use or disclose your protected health information without your permission in the following way:

In certain circumstances, we are required by law to make a disclosure of your health information.  For example, state law requires us to report suspected child abuse or neglect.  Also, we must disclose information to the Department of Health and Human Services, if requested, to prove that we are complying with regulations that safeguard your health information.

We are Allowed to make use or disclose your protected health information without your permission in the following ways:

There are certain circumstances where we are allowed to disclose information from your record without your permission. In these situations, we must use our professional judgment before disclosing information about you.  Usually, we must determine that the disclosure is in your best interest, and may have to meet certain guidelines and limitations.

If you receive mental health care, including treatment for substance abuse, information related to that care maybe more protected than other forms of health information.  Communications between a psychotherapist and patient in treatment are privileged and may not be disclosed without your permission, except as required by law.  For example, psychotherapists still must report suspected child abuse, and may have to breach confidentiality if you appear to pose an imminent danger to yourself or to others, in order to reduce the likelihood of harm to you or to others.

We MAY:
  • Use or disclose information from your record if we believe it is necessary to prevent or lessen a serious and imminent threat to the safety of a person or the public.  We may report suspected cases of abuse, neglect, or domestic violence involving adult or disabled victims.
  • Report births and deaths to public health authorities, as well as certain diseases, injuries, adverse drug reactions, and product defects.  We may disclose information from your record to a medical examiner or coroner.  We may disclose information to funeral directors to allow them to carry out their duties upon your death.  We may disclose information from your record to facilitate organ, eye or tissue donation and transplantation.
  • Assist in health oversight activities, such as investigations of possible health care fraud.

We may disclose information from your record:
  • As authorized by worker’s compensation laws
  • If ordered to do so by a court, grand jury, or administrative tribunal.  Under certain conditions, we may disclose information in response to a subpoena or other legal process, even if this is not ordered by a court.
  • To a law enforcement official if certain criteria are met.  For example, if such information would help locate or identify a missing person, we are allowed to disclose it.
  • For research under certain conditions.

If you tell us that you have committed a violent crime that caused serious physical harm to the victim, we may disclose that information to law enforcement officials.  However, if you reveal that information in a counseling or psychotherapy session, in  the course of treatment for this sort of behavior, we may not disclose the information to law enforcement officials.

Under certain conditions, we may disclose information for specialized government purposes, such as the military, national security and intelligence, or protection of the President.

IF APPLICABLE:
We (our staff) may contact you to provide appointment reminders as a courtesy.  However, you are responsible for remembering your appointment.

We may contact you with information about treatment alternatives or other health-related benefits or services that may be of interest to you

We may contact you for fundraising efforts.


Issues that are addressed at Green Leaves:Alcohol and drug issuesRelationshipsCommunication SkillsParenting SkillsAnger ManagementVictims of crime issuesAnxietyDepressionBipolar DisorderPre-marital counselingSexual and physical abuse                issuesDomestic violenceTraumaLife changes skills
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