Contents of all therapy sessions are confidential. Both verbal information and written records
about a client cannot be shared with another party without the written consent of the client or the
client’s legal guardian. Noted exceptions are as follows:

Duty to Warn and Protect
When a client discloses intentions or a plan to harm another person, the mental health professional is
required to warn the intended victim and report this information to legal authorities. In cases in which
the client discloses or implies a plan for suicide, the health care professional is required to notify legal
authorities and make reasonable attempts to notify the family of the client.

Abuse of Children and Vulnerable Adults
If a client states or suggests that he or she is abusing a child (or vulnerable adult) or has recently abused a
child (or vulnerable adult), or a child (or vulnerable adult) is in danger of abuse, the mental health
professional is required to report this information to the appropriate social service and/or legal authorities.

Prenatal Exposure to Controlled Substances
Mental Healthcare professionals arerequired toreport admitted prenatal exposure to controlled
substances that are potentially harmful.

Minors/Guardianship
Parents or legal guardians of non-emancipated minor clients have the right to access the clients’ records.

Insurance Providers (when applicable)
Insurance companies and other third-party payers are given information that they request regarding
servicesto clients.Information that may be requested includestype ofservices, dates/times ofservices,
diagnosis, treatment plan, and description of impairment, progress of therapy, case notes, and
summaries.
I agree to the above limits of confidentiality and understand their meanings and ramification