Abou-Zaki & Associates

PRIVACY & CONFIDENTIALITY

It is Abou-Zaki & Associates legal and ethical obligation to keep any information about you and your therapy confidential. There are certain limits to your right to confidentiality, which are explained in detail below. This office is compliant with the privacy rules of the Federal Health Insurance Portability and Accountability Act (HIPPA) of 1996. All information between therapist and client is strictly confidential. By law, information concerning our professional relationship can be released only with the client’s prior written consent.

While this written summary of exceptions to confidentiality should prove helpful in informing you about potential problems, it is important that we discuss any questions or concerns that you may have at our next meeting. Please note that the confidentiality of email communication is not guaranteed to be secure and I try to avoid this mode as much as possible. I will on occasion use email (with your permission) to arrange for appointment scheduling or other communications. If you do not wish me to use email- please inform me directly and in writing.

In regards to the Clinical Records involving a couple or family members, it is important to know that anyone who is a client and attended a session(s) jointly may have access to a complete copy of the file, under the circumstances described in the Agreement. That means that in my chart notes, information about each person involved in the therapy may be available to the other(s) without further consent. In making this agreement, it is recognized that either party might further disclose information obtained from this file and I have no control over such rerelease of information. If an “outside” third party wishes to access the file, signatures of both partners/spouses will be required in order to release the requested information. Certain exceptions to these confidentiality and access provisions may be required by law.

Exceptions to Confidentiality:

have contact or communication with client for a period of 30 days, it will assume that client no longer intends to

remain active in the therapeutic relationship and client case will be closed. Client can return to therapy in the

future if they decide to continue treatment.

1)

1) Consultation: I may consult with other licensed professionals regarding my clients; however, the client’s name or other identifying information is never disclosed. The client’s identity remains completely anonymous and confidentiality is fully maintained.

2) If you file a worker’s compensation claim, and your psychotherapy is relevant to the injury involved in your claim, if properly requested, I must provide a copy of your record to your employer and the Department of Labor and Industries.

3) If I have reasonable suspicion that a child has suffered abuse or neglect, the law requires that I file a report with the appropriate government agency.

4) If I have reasonable cause to believe threat abandonment abuse, financial exploitation or neglect of a vulnerable adult has occurred, the law requires that I file a report with the appropriate government agency.

5) If I have reason to believe you or someone else is in imminent danger, I may be required to take protective actions, including notifying potential victims, contacting the police, seeking hospitalization for your or contacting family members or other who can help provide for your protection.

6) I am required to report myself or another healthcare provider in the event of a final determination of unprofessional conduct, a determination of risk to patient safety due to a mental or physical condition, or if I have actual knowledge or unprofessional conduct.

7) In the event of a court order or subpoena, I may be required to disclose information.

8) Information that may jeopardize my safety will not be kept confidential.

9) In the event of a medical emergency, emergency personnel may be given necessary information.

10) If you file a complaint or lawsuit against me, I am permitted to disclose information as relevant for my

defense.

In the event of the client’s death or disability, the information may be released if the client’s personal

representative or the beneficiary of an insurance policy on the client’s life signs a release authorizing disclosure.

If therapist does not

Email Communication/Technology Agreement

I understand that Abou-Zaki & Associates, will use reasonable means to protect the security and confidentiality of email sent and received. However, there are known and unknown risks that may affect the privacy of personal health care information when using email to communicate. These risks include, but are not limited to:

• Email can be forwarded, printed and stored in numerous paper and electronic forms and be received by unintended recipients without my knowledge or agreement

• Email may be sent to the wrong address by any sender or receiver.

• Email is easier to forge than handwritten or signed papers.

• Copies of email may exist even after the sender or receiver has deleted his or her copy.

• Email service providers have a right to archive and inspect emails sent through their systems.

• Email can be intercepted, altered, forwarded, or used without detection or authorization.

• Email can spread computer viruses.

• Email delivery is not guaranteed

By signing below, you agree not to use email for emergencies or to send time sensitive information. It is also agreed that it is your responsibility to follow up with Abou-Zaki & Associates if you have not received a response to an email within a reasonable time period. By signing below, you give permission for Abou- Zaki & Associates to send email messages that may include patient health care information and you acknowledge that you have read and understand the risks of using email as stated above. If you wish to not use email or wish to stop using email as means of communication please request immediately and in writing to Abou-Zaki & Associates

I do not use social media sites to maintain contact with clients. If you send me a request to be part of your network or to be part of mine, I will not accept; this is to protect your confidentiality and privacy as well as my own and also to maintain the professional nature of our therapy relationship. Additionally, I do not communicate by private or text messaging.

If you use location services on your phone or check-in functionally on many smart phone apps, please be aware that you’re confidentially and privacy regarding your engagement in therapy may be compromised.

Communications by phone, text or email and outside of my office will be treated as confidential though their confidentiality cannot be guaranteed. The content of phone calls and emails should not be construed as and is not a substitute for therapy. Communication outside of my office, by phone, email, text or other means should be used for non-therapeutic purposes only (unless otherwise stated below) such as for scheduling. Even in such a case, the confidentiality cannot be guaranteed. You are responsible for information included in communications from you outside my office.