Confidentiality Statement
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Document Number: COUNS--103
Revision #: 2.0
Document Owner: Dean of Students
Date Last Updated: 12/18/2017
Primary Author: Director of Counseling/Disability Services Center
Status: Approved
Date Originally Created: 02/16/2012
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General Description
Description: Information about the confidentiality statement relative to Counseling Center policy.
Purpose: Delineation of policy.
Scope: Students
Responsibility: Counseling Services
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In order to comply with this policy you should know:
Current University policy
Standards of good practice
Terms and Definitions: Additional training
Corrective Action
Loss of privilege, general
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Policy Provisions
1. Confidentiality Statement
Confidential information may not be released or discussed with anyone, other than Center clinical staff without the written consent of the client, except in accordance with law. The Authorization for Release of Information (Appendix H) form must be signed and dated by the client for the form to be valid. All records released by the Counseling Center will be stamped “Confidential…This information may not be re-released.”
Requests for information from government agencies and attorneys or by court order or subpoena will be honored only upon advice of the University’s legal counsel and in accordance with the law. A signed consent must be obtained whenever confidential information is to be released to a person or agency outside the Counseling Center, including to Cumberland University staff and faculty.
It is important to note that Residential Life staff and other campus offices have their own guidelines for the reporting of critical information and incidents, and are often accustomed to freer sharing of information in their work environment than is allowable for counselors. They may need to be reminded from time to time that counselors are ethically and legally bound to much tighter constraints in this regard, and do not have the prerogative to share some types of information which other campus staff might ordinarily expect to exchange.
COUNS--103 APPENDIX H CUCC Authorization for Release of Information
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Performance Evaluation
Performance Metrics: Compliance with standard policy and procedure
Consequences: Further training
Loss of privileges
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Subject Experts
The following may be consulted for additional information.
Dean of Students
Director of Counseling/Disability Services Center