NOTICE OF CLIENT CONFIDENTIALITY of Alcohol/Drug Abuse and Mental Health Client Records

Federal laws and regulations protect the confidentiality of alcohol/drug abuse and mental health client records maintained by PathLight Counseling. Generally, PathLight Counseling may not say to a person outside the program that a client attends the program, or disclose any information identifying a client as an alcohol or drug abuser, unless:

1. The client consents in writing.
2. The disclosure is allowed by a court order.
3. The disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit, or program evaluation.

Violation of the federal law and regulations by a program is a crime. Suspected violations may be reported to appropriate authorities in accordance with federal regulations. Federal laws and regulations do not protect any information about a crime committed by a client either at the program or against any person who works for the program or about any threat to commit such a crime. Federal laws and regulations do not protect any information about suspected child abuse or neglect from being reported under state law to appropriate state or local authorities.

(See 42 U.S.C. 290dd-3 and 42 U.S.C. 290ee-3 for Federal laws and 42 CFR part 2 for regulations)

April 24, 2024

Print - Name of Patient or Parent(s)/Guardian(s)

Leave this empty:

Signature arrow sign here


Signature Certificate
Document name: NOTICE OF CLIENT CONFIDENTIALITY
lock iconUnique Document ID: e4ffc68ec034f8f90aafefc6b3ad8e358e539954
Timestamp Audit
July 27, 2022 4:59 pm -02NOTICE OF CLIENT CONFIDENTIALITY Uploaded by Britt Parramore - support@allydrez.com IP 162.239.100.54