
| About Confidentiality I will treat with great care all the information you share with me. It is your legal right that our sessions and my records about you be kept private. That is why I ask you to sign a “release-of-records” form before I can talk about you or send my records about you to anyone else. In general, I will tell no one what you tell me. I will not even reveal that you are receiving treatment from me. In all but a few rare situations, your confidentiality (that is, your privacy) is protected by state law and by the rules of my profession. Here are the most common cases in which confidentiality is not protected: 1. If you were sent to me by a court or an employer for evaluation or treatment, the court or employer expects a report from me. If this is your situation, please talk with me before you tell me anything you do not want the court or your employer to know. You have a right to tell me only what you are comfortable with telling. 2. Are you suing someone or being sued? Are you being charged with a crime? If so, and you tell the court that you are seeing me, I may then be ordered to show the court my records. Please consult your lawyer about these issues. 3. If you make a serious threat to harm yourself or another person, the law requires me to try to protect you or that other person. This usually means telling others about the threat. I cannot promise never to tell others about threats you make. 4. If I believe a child, elderly person, resident of an institution, or a disabled person has been or will be abused or neglected, I am legally required to report this to the authorities. 5. If a law enforcement official requires me to do so. 6. For Workers Compensation and similar benefit programs. There are two situations in which I might talk about part of your case with another therapist. I ask now for your understanding and agreement to let me do so in these two situations. First, when I am away from the office for a few days, I may have a trusted fellow counselor “cover” for me. This counselor will be available to you in emergencies. Therefore, s/he needs to know about you. Of course, this counselor is bound by the same laws and rules as I am to protect your confidentiality. Second, I sometimes consult other counselors or other professionals about my clients. This helps me in giving high-quality treatment. These persons are also required to keep your information private. Your name will never be given to them, and they will be told only as much as they need to know to understand your situation. For the purpose of these consultations, I may want to make audio or video recordings of our sessions. I will review the recordings with my consultant to assist with your treatment. I will ask your permission to make any recording. I promise to destroy each recording as soon as I no longer need it, or, at the latest, when I destroy your case records. You can refuse to allow this recording, or can insist that the recording be edited. Except for the situations I have described above, my office staff and I will always maintain your privacy. I also ask you not to disclose the name or identity of any other client being seen in this office. My office staff makes every effort to keep the names and records of clients private. My staff and I will try never to use your name on the telephone, if clients in the office can overhear it. All staff members who see your records have been trained in how to keep records confidential. If your records need to be seen by another professional, or anyone else, I will discuss it with you. If you agree to share these records, you will need to sign a release form. This form states exactly what information is to be shared, with whom, and why, and it also sets time limits. You may read this form at any time. If you have questions, please ask me. It is my office policy to destroy clients’ records 15 years after the end of our therapy. Until then, I will keep your case records in a safe place. If I must discontinue our relationship because of illness, disability, or other presently unforeseen circumstances, I ask you to agree to my transferring your records to another counselor who will assure their confidentiality, preservation, and appropriate access. If we do family or couples counseling (where there is more than one client), and you want to have my records of this counseling sent to anyone, all of the adults present will have to sign a release. As part of cost control efforts, an insurance company will sometimes ask for more information on symptoms, diagnoses, and my treatment methods. It will become part of your permanent medical record. I will let you know if this should occur and what the company has asked for. Please understand that I have no control over how these records are handled at the insurance company. My policy is to provide only as much information as the insurance company will need to pay your benefits. You can review your own records in my files at any time. You may add to them or correct them, and you can have copies of them. I ask you to understand and agree that you may not examine records created by anyone else and sent to me. In some very rare situations, I may temporarily remove parts of your records before you see them. This would happen if I believe that the information will be harmful to you, but I will discuss this with you. |

| Sometimes all we need is a listening ear, a helping hand and a caring heart to find balance in our lives. |

| Terry McVannel Erwin, Ph.D. Dr. Erwin is a General Practitioner With a Special Interest in Working with Women Survivors of Childhood Sexual Abuse Certified Hypnotherapist Qualified Supervisor, Florida National Certified Counselor #78891 Licensed Mental Health Counselor #MH8591 |
| HOME DR. ERWIN'S SPECIALTIES IS COUNSELING RIGHT FOR YOU? PERSONAL STATEMENT ABOUT COUNSELING ABOUT HYPNOTHERAPY COST OF SERVICES CONTACT DR. ERWIN PLEDGE TO LGBT CLIENTS AFFIRMATIONS AND MORE PAPERWORK FOR NEW CLIENTS DIRECTIONS TO OUR OFFICE 2506 Del Prado Boulevard South Cape Coral, FL 33904-4750 Ph. (239) 242-0545 TErwin1@yahoo.com MOST INSURANCES ACCEPTED Don't have insurance? We offer limited-session sliding scale fees that are comparable to insurance co-pays! Call today for more information! |
