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Confidentiality & Release of Information Form

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Counseling & Human Development Information About Confidentiality and How to Get Help

Peonies in front of Dick's HouseThe Office of Counseling and Human Development (CHD) is dedicated to providing high-quality health care. We maintain a confidentiality policy which respects privacy and promotes better healthcare. To promote understanding of confidentiality we are providing you with detailed information on CHD's policy and confidentiality and New Hampshire (NH) laws on privileged communication between clients and a mental health professional. In addition, a copy of the Mental Health Bill of Rights is posted in our waiting area.

Mental health records are confidential. However, there are exceptions to maintaining strict confidentiality.  NH law requires mental health professionals to share information regarding child abuse/neglect, elderly /incapacitated adult abuse/neglect, serious physical threats to others, and serious threats to real property, and injuries related to gunshot or criminal acts. There are specific circumstances such as emergencies or on-call matters in which CHD mental health providers may give or seek information from previous, current or subsequent providers to enable coordination of care in your best interest.  If we think you are in imminent danger of serious self-harm we may communicate with other providers, college administration or Safety and Security, other public safety departments, or your family.

It is important for you to know that NH general laws outline a protected relationship between mental health professionals and clients equivalent to attorney-client privilege. This privileged relationship means that clinicians may not reveal or be compelled to reveal any communication, observation, test result, or other information gained as a result of the treatment relationship without your consent except as noted. Information conveyed to CHD about you by someone else is not considered confidential and may be shared with you. Privileged communication between a client  and a mental health professional may be abrogated by court order in limited circumstances.

To provide you with the best possible care, there may be times when we will need to contact or respond to you via email, cell phone, or voice mail/answering machine. We ask you which of these methods are acceptable to you.  It is important to note that there is the potential that these messages could be inadvertently received or overheard by an unintended third party.

Counseling records are maintained within the electronic medical record of the Dartmouth College Health Service; however, only CHD staff are allowed to access counseling notes.

Professional ethical guidelines are clear that sexual contact between a mental health professional and a client is always unethical and a serious violation of professional practice.

If your psychological issues are substantially affecting your ability to learn, you may be eligible under the Americans with Disabilities Act (ADA) to register for psychiatric disability status and academic accommodations through Student Accessibility Services (SAS).

If you have any questions on confidentiality, procedures, or the Bill of Rights, please ask your mental health provider.  We encourage you to help us maintain high-quality healthcare by your active participation.

Last Updated: 7/11/14