Authorization for Release of Information

It is considered best practice to assemble the most comprehensive history possible on each patient. It is also considered best practice to coordinate care with all other professionals involved in the treatment of a given individual. However, none of that can be done without your written permission. In order to get the best treatment possible, you should print, fill out, and sign as many authorizations as are appropriate, based on the following list:

  1. Primary Care Physician (PCP) – Everyone is encouraged to fill one out for their PCP, especially anyone who is taking any medication.
  2. Other Medical Doctors – If you are seeing anyone else besides your PCP for medical treatment, it might be a good idea for Dr. Archer to review those records and/or notify that person that you are being seen at Down To Earth. Examples include: neurologist, naturopathic doctor, chiropractor, or a gynecologist that is providing specialized treatment.
  3. Current or Past Psychiatrists or Psychiatric Nurse Practitioners – You should fill out one authorization for each psychiatric professional that did an evaluation or provided any treatment or medications to you, especially if you still see them.
  4. Current or Past Therapists – You should fill out one authorization for each therapist that you have seen in the past and any that you are currently seeing. It is not generally a great idea to see two therapists at once, so that is something that we’d probably want to discuss before you begin treatment with us. If there is a good reason to see two therapists, you can certainly continue, but it will probably be better to go with one or the other.
  5. School – For every client under 18, an authorization should be filled out for the child’s school so Dr. Archer can get relevant records, coordinate care with the client’s teacher, counselor, or school psychologist. If the problem is not related to school at all, it may still be a good idea for the school to know that the child is seeing someone outside of school in case something happens at school and the teacher or someone else wants to contact Dr. Archer. Also, what we have found out, over the years, is that often a crisis will happen at school and the parent will want us to quickly call a teacher that day to give the teacher some information and without a release, we cannot, so we tend to just ask parents to do this up front so that it is on file, just in case. Adults who had a lot of problems in school, were in Special Education, had Individualized Education Plans (IEPs), or whose issues are influencing their academic performance in college may want to sign authorizations that allow Dr. Archer to review their old school records or that allow Dr. Archer to communicate with their current instructors or advisors.
  6. Employer – Only those people who will want Dr. Archer to fill out work-related documents like FMLA forms or provide proof of attendance at sessions should fill out an authorization to their employer.
  7. Probation or Parole Officer – Anyone who is on probation or parole should fill out and sign an authorization so Dr. Archer and your P.O. can exchange information.
  8. Legal Guardian – All children over 14 should sign an authorization for release of information to their legal guardians so that Dr. Archer can keep their parents informed about their general progress in treatment. All adults with legal or financial guardians should also sign a release so Dr. Archer can communicate treatment plans with the guardian.
  9. Private Citizens – Anyone who wants the doctor to speak with any non-custodial relatives or friends must fill out an authorization for release of information or the doctor cannot do so. Some examples might be: a 19 year old brother who drives a 15 year old client to sessions, grandparents, non-married significant others, roommates.

Next – Fill out Authorizations

Comments are closed.