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Confidentiality Agreement-Letter Format - Therapy or Counseling Services

State:
Multi-State
Control #:
US-70006NMS
Format:
Word; 
Rich Text
Instant download

Description

Agreement of confidentiality between the patient/client and therapist (Psychologist/Psychiatrist) for individual or group sessions concerning disclosure of information of patient/client unless legally and/or ethically deemed to be an exception. State and Federal law compliant. This confidentiality agreement is prepared in a letter format and requires the patient/client signature.

A Confidentiality Agreement-Letter Format — Therapy or Counseling Services is a legally binding document between a therapist and client that outlines the terms of a confidential relationship, including the type of information that will remain private and what is to be disclosed. This type of agreement is commonly used in the field of mental health, as it helps to ensure the safety and privacy of both parties involved in the therapeutic process. There are two main types of Confidentiality Agreement-Letter Format — Therapy or Counseling Services: Standard Confidentiality Agreement and HIPAA Confidentiality Agreement. The Standard Confidentiality Agreement outlines the general confidentiality obligations of the therapist and client, including the information that must remain private and confidential. The HIPAA Confidentiality Agreement is more detailed and includes specific requirements that must be followed in order to comply with the Health Insurance Portability and Accountability Act (HIPAA). The Confidentiality Agreement-Letter Format — Therapy or Counseling Services should include the names of the parties involved, the date of the agreement, the obligations of both parties, and a signature block. It should also include any exceptions to the agreement, such as when the therapist may be legally required to disclose confidential information, or when the information may be shared with a third party.

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FAQ

Examples of confidentiality clauses include: Example 1: Preventing employees from talking to the press. Example 2: Limiting the disclosure of on-site business practices. Example 3: Stopping business partners from sharing IP rights.

Describe what the other party is agreeing to. Exercising reasonable precautions against disclosure of the information. Not disclosing Confidential Information without the written consent of the Disclosing Party. Using the information only for business purposes, and only on a ?need to know? basis.

For licensed mental health professionals, confidentiality is protected by state laws and the Health Insurance Portability and Accountability Act (HIPAA). Therapists who break confidentiality can get in trouble with state licensing boards. They can also be sued by their clients in some cases.

This agreement is made between ("Employee") and Company Name on 20. Employee will perform services for Company Name that may require Company Name to disclose confidential and proprietary information ("Confidential Information") to Employee.

I acknowledge that all Information is strictly confidential and I agree that I shall not reveal to any person or entity, or use any Information at any time, except as expressly directed by firm, or as may be required by law.

Do: discuss confidentiality with your client at the contracting stage. be clear about the possible exceptions to confidentiality. be explicit about who you may need to share their information with, and who else has access to their records. explain that you need to discuss your casework with a supervisor.

I cannot and will not tell anyone else what you have told me, or even that you are in therapy with me without your prior permission. You can authorize me to share information with whomever you choose, and you may change your mind and revoke that permission at anytime.

A typical confidentiality clause might say, "The phrases and circumstances of this Agreement are completely confidential between the parties and shall not be disclosed to anybody else. Any disclosure in violation shall be deemed a breach of this Agreement."

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Confidentiality Agreement-Letter Format - Therapy or Counseling Services