To our valued clients:
We are required to have on file sensitive information about you and perhaps your family. All possible means are taken to preserve that data from disclosure to another individual or entity. No data shall be shared with another person or entity without your expressed, written consent, except in the cases defined in our Consent for Counseling and Fee Agreement form (for example, danger to self or others or child abuse).If you wish information to be shared with or supplied to anyone outside of our agency, including yourself, you will be asked to sign a waiver releasing us from responsibility for that data. You will be asked to supply the name, address, and phone number of the person to whom the data is to be released and the specific data that you wish released to that person.
Your signature on our intake form allows us to provide necessary information to your insurance company in order to collect for claims. If you have questions about our HIPAA compliance, please contact our central office at 480-969-2783.