Alaska
| You understand that your primary care provider may obtain a copy of your records of your telehealth encounter. This document is intended to provide you with all of the information is required by the Board of Professional Counselors which regulates all licensed professional counselors. You may contact the Board with any questions or concerns. Alaska Stat. § 08.63.210(c)(2).
| Board of Professional Counselors Division of Corporations, Business & Professional Licensing P.O. Box 110806 Juneau, AK 99811-0806 Phone: (907) 465-2551 Email: [email protected] |
Arizona
| You are entitled to all existing confidentiality protections, including where a provider may only disclose all or part of your medical record and payment record as authorized by state or federal law or written authorization signed by you or your health care decision maker, pursuant to A.R.S. § 12-2292. You also understand all medical reports resulting from the telemedicine consultation are part of your medical record as defined in A.R.S. § 12-2291. You also understand dissemination of any images or information identifiable to you for research or educational purposes shall not occur without your consent, unless authorized by state or federal law. Ariz. Rev. Stat. Ann. § 36-3602(D). See also Ariz. Admin. Code § 4-6-1101. Pursuant to Ariz. Admin. Code § 4-6-1102 your provider will: 1. Work jointly with you or your legal representative (as applicable) to prepare an integrated, individualized, written treatment plan, based on the provider’s provisional or principal diagnosis and assessment of behavior and the treatment needs, abilities, resources, and circumstances of you that includes: a. One or more treatment goals; b. One or more treatment methods; c. The date when your treatment plan will be reviewed; d. If a discharge date has been determined, the aftercare needed; e. The dated signature of your or your legal representative; and f. The dated signature of the provider; 2. Review and reassess the treatment plan: a. According to the review date specified in the treatment plan as required under subsection (1)(c); and b. At least annually with the you or your legal representative to ensure the continued viability and effectiveness of the treatment plan and, where appropriate, add a description of the services you may need after terminating treatment with the provider. 3. Ensure that all treatment plan revisions include the dated signature of you or your legal representative and the provider; 4. Upon written request, provide you or your legal representative an explanation of all aspects of your condition and treatment; and 5. Ensure that your treatment is in accordance with your treatment plan.
| Board of Behavioral Health Examiners 1740 West Adams Street, #3600 Phoenix, AZ 85007 Main Number: 602-542-1882 Fax Number: 602-364-0890 [email protected] |
California
| You understand that you have the right to withhold or withdraw your consent to the use of telehealth in the course of your care at any time, without affecting your right to future care or treatment, or, affecting your ability to access covered services from Medi-Cal in the future. You understand that you have the right to access Medi-Cal covered services through an in-person, face-to-face visit or through telehealth. You understand that Medi-Cal provides coverage for transportation services to in-person services when other resources have been reasonably exhausted. Cal. Welf. & Inst. Code Ann. § 14132.725(d)).
| B1625 North Market Blvd., Suite S200, Sacramento, CA 95834 Telephone: (916) 574-783 |
Colorado
| You are entitled to the consent requirements outlined under 2 CO ADC 502-1:21.170.4. The confidentiality of your individual records, including all medical, mental health, substance use, psychological, and demographic information shall be protected with the applicable state and federal laws and regulations, as provided under 2 CO ADC 502-1:21.170.2. 2 CO ADC 502-1:21.170.2. You understand that your mental health records may not be maintained after the seven-year period for filing a complaint pursuant to Colorado Rev. Stat. 12-245-226 (1)(a)(II)(A). You further understand, in accordance with Colorado Rev. Stat. 12-245-216: I. You are entitled to receive information about the methods of therapy, the techniques used, the duration of therapy, if known, and the fee structure; II. You may seek a second opinion from another therapist or may terminate therapy at any time; III. In a professional relationship, sexual intimacy is never appropriate and should be reported to the board that licenses, registers, or certifies the licensee, registrant, or certificate holder (located at the right). IV. The information provided by you during therapy sessions is legally confidential in the case of individuals licensed, certified, or registered pursuant to this article 245, except as provided in section 12-245-220 and except for certain legal exceptions that will be identified by the licensee, registrant, or certificate holder should any such situation arise during therapy. If an unlicensed psychotherapist is involved in your care, you understand that such provider is a psychotherapist listed in the state’s database and is authorized by law to practice psychotherapy in Colorado but is not licensed by the state and is not required to satisfy any standardized educational or testing requirements to obtain a registration from the state. You have been provided in writing the following information regarding your provider: • The name, business address, and business phone number of the licensee, registrant, or certificate holder
| The practice of licensed or registered persons in the field is regulated by the below Divisions: State Board of Licensed Professional Counselor Examiners, State Board of Social Work Examiners, State Board of Marriage and Family Therapist Examiners, State Board of Addiction Counselor Examiners, and State Board of Psychologist Examiners. 1560 Broadway, Suite 1350, Denver, Colorado 80202, (303) 894-7800, Email: [email protected] B1625 North Market Blvd., Suite S200, Sacramento, CA 95834 Telephone: (916) 574-783 |
Connecticut
| You understand that each telehealth provider shall, at the time of the initial telehealth interaction, ask you whether you consent to that provider’s disclosure of records concerning the telehealth interaction to your primary care provider. You further understand that your primary care provider may obtain a copy of your records of your telehealth encounter, upon your consent. Conn. Gen. Stat. Ann. § 19a-906(d).
| Connecticut Department of Public Health. Professional Counselor Licensure. 410 Capitol Ave., MS #12 APP, P.O. Box 340308, Hartford, CT 06134, Phone:(860) 509-7603 Fax:(860) 707-1980 Email: [email protected] |
District of Columbia
| You have been informed of alternate forms of communication between you and a physician for urgent matters. D.C. Mun. Regs. tit. 17, § 4618.10. Relevant communications with the physician, including those done via electronic methods shall be documented and filed in your medical record. D.C. Mun. Regs. tit. 17, § 4618.9.
| Professional Counseling Licensing 899 North Capitol Street, NE, Washington, DC 20002 Phone: (202) 442-5955 Fax: (202) 442-4795 Department of Health Board of Medicine 899 North Capitol Street, NE Washington DC, 20002 Email: [email protected] |
Georgia
| You have been given clear, appropriate, accurate instructions on follow-up in the event of needed emergent care related to the treatment. Ga. Comp. R. & Regs. 360-3-.07(a)(7).
| Georgia Composite Medical Board 2 Peachtree Street, NW 6th Floor Atlanta, GA 30303-3465 Email: [email protected] |
Idaho
| If you need to register a formal complaint about a physician, you may visit the medical board’s website, here. Idaho Guidelines for Appropriate Regulation of Telemedicine. You further understand that your informed consent for the use of telehealth services shall be obtained by applicable law. Idaho Statutes 54-5708.
| Board of Medicine: Logger Creek Plaza 345 Bobwhite Ct., Suite 150 Boise, ID 83706 [email protected] Division of Professional Licenses: 11351 W. Chinden Blvd., Bldg. #6 Boise, ID 83714 |
Indiana
| If a prescription is issued to you, and subject to your consent the prescriber shall notify your primary care provider of any prescriptions the prescriber has issued for you if the primary care provider's contact information is provided by you. This requirement does not apply if: (A) The practitioner is using an electronic health record system that your primary care provider is authorized to access. (B) The practitioner has established an ongoing provider-patient relationship with the patient by providing care to the patient at least 2 consecutive times through the use of telehealth services. If the conditions of this clause are met, the practitioner shall maintain a medical record for you and shall notify your primary care provider of any issued prescriptions. Ind. Code Ann. 25-1-9.5-7. As a Medicaid patient, you have the right to choose between an in-person visit or telehealth visit. Indiana Medicaid Manual: Telehealth and Virtual Services.
| Professional Licensing Agency Attn: [insert relevant profession] 402 W. Washington Street, Room W072 Indianapolis, Indiana 46204 Email: [email protected] Phone Number: (317) 234-2060 |
Iowa
| To file a complaint, fill in the form below or fill out the complaint form and email it to the medical board at [email protected]. Iowa Admin. Code 653-13.11(147,148,272C)(13.11(18)). As appropriate your provider will identify the medical home or treating physician(s) for you, when available, where in-person services can be delivered in coordination with the telemedicine services. Your provider shall provide a copy of the medical record to your medical home or treating physician(s).Iowa Admin. Code 653-13.11(147,148,272C)(13.11(11)).
| Iowa Board of Medicine Dept. of Inspections, Appeals, & Licensing 6200 Park Avenue Suite 100 Des Moines, IA 50321 |
Kansas
| You understand that if you have a primary care or other behavioral health treating provider and if you consent to us sharing your information with such provider, then we are obligated to send within three business days a report to such primary care or other treating physician of the treatment and services rendered by Backpack Healthcare during the telemedicine encounter. Kan. Stat. Ann. § 40-2,212(2)(d)(2)(A). You have been informed whether your licensed psychologist has either a master's degree or a doctoral degree. If your licensed psychologist has a doctoral degree, you have been informed whether or not such doctoral degree is a doctor of medicine degree or some other doctoral degree. If your licensed psychologist does not have a medical degree, you understand they are not authorized to practice medicine nor prescribe drugs. Kan Stat. Ann. § 74-5350.You understand some licensees are not authorized to practice medicine and surgery and are not authorized to prescribe drugs. You have been advised that certain mental disorders can have medical or biological origins, and that you should consult with a physician. Kan. Stat. Ann. §65-5817.
| Kansas Board of the Healing Arts 800 SW Jackson, Lower Level - Suite A, Topeka, KS 66612 (785) 296-7413; Fax (785) 368-7102 |
Kentucky
| You have been informed that if you want to register a formal complaint about a provider, you should visit the medical board’s website, here. Information related to filing grievances may be found here: Kentucky Board Opinion on the Use of Telemedicine Technologies (2014), as amended September 15, 2022. If requested by you, your physician must share the medical record with your primary care physician and other relevant members of your existing care team. Kentucky Board Opinion on the Use of Telemedicine Technologies (2014), as amended September 15, 2022.
| Kentucky Board of Medical Licensure 310 Whittington Parkway Suite 1B Louisville, KY 40222 |
Louisiana
| You understand the role of other health care providers that may be present during the consultation, other than the Backpack Healthcare provider. 46 La. Admin. Code Pt XLV, § 7511.
| Licensed Professional Counselors Board of Examiners 11410 Lake Sherwood Ave North Suite A Baton Rouge, LA 70816 225-295-8444 (phone) 225-295-8448 (fax) [email protected] |
Maine
| If you have a concern or complaint about the mental health professionals providing care to you, you may contact a board agency to assist you. If you want to register a formal complaint about a physician, you should visit the medical board’s website, here. Code Me. R. tit. 02-373 Ch. 11, § 3.
| Complaint Coordinator Office of Licensing and Registration 35 State House Station Augusta, ME 04333 Tel: (207) 624-8660 www.maine.gov/professionallicensing |
Maryland
| Information provided in this consent is required by the Board of Professional Counselors and Therapists, which regulates all licensed and certified counselors and therapists. Maryland Health & Occ. Code § 17-507.
| Board of Professional Counselors and Therapists 4201 Patterson Ave., Baltimore, MD 21215 Fax: (410) 358-1610 https://health.maryland.gov/bopc/Pages/complaintold.aspx |
Michigan
| If you have a concern or complaint about the mental health professionals providing care to you, you may contact a board agency to assist you. Mich. Comp. Law 333.18113.
| Professional Licensing, Department of Licensing and Regulatory Affairs Ottawa Building 611 W. Ottawa P.O. Box 30004 Lansing, MI 48909 Phone: 517-241-0199 Fax: 517-241-9416 [email protected] |
Nebraska
| If you are a Medicaid recipient, you retain the option to refuse the telehealth consultation at any time without affecting your right to future care or treatment and without risking the loss or withdrawal of any program benefits to which the patient would otherwise be entitled. All existing confidentiality protections shall apply to the telehealth consultation. You shall have access to all medical information resulting from the telehealth consultation as provided by law for access to your medical records. Dissemination of any patient identifiable images or information from the telehealth consultation to researchers or other entities shall not occur without your written consent. You understand that you have the right to request an in-person consult immediately after the telehealth consult and you will be informed if such consult is not available. Neb. Rev. Stat. Ann. § 71-8505; 471 Neb. Admin. Code § 1-006.05.
| Nebraska DHHS Licensure Unit Attn: [insert relevant profession] PO Box 94986 Lincoln NE 68509-4986 Complaints: https://dhhs.ne.gov/Pages/Complaints.aspx |
New Hampshire
| You understand that the provider may forward your medical records to your primary care or treating provider. N.H. Rev. Stat. § 329:1-d.
| Office of Professional Licensure & Certification 7 Eagle Square Concord NH, 03301 Phone: 603-271-2152 |
New Jersey
| You understand that you have the right to request a copy of your medical information and you understand your medical information may be forwarded directly to your primary care provider or health care provider of record, or upon your request, to other health care providers. If you do not have a primary care provider or other health care provider of record, the health care provider engaging in telemedicine or telehealth may advise you to contact a primary care provider, and, upon request by you, may assist you with locating a primary care provider or other in-person medical assistance that, to the extent possible, located within reasonable proximity to you. N.J. Rev. Stat. Ann. § 45:1-62.
| New Jersey Board of Medical Examiners [email protected] (609) 826-7100 Professional Counselors Examiners [email protected] (973) 504-6582 |
Ohio
| You understand that the provider may forward your medical records to your primary care or treating provider. Ohio Admin. Code 4731-37-01(C)(4).You have been advised of our fees. This information is required by the counselor, social worker, and marriage and family therapist board, which regulates the practices of professional counseling, social work, and marriage and family therapy in this state. Ohio Rev. Code § 4757.13.
| Ohio Medical Board Complaints may be sent to: [email protected] or call the Medical Board at 614-466-3934 and choose option 1 to speak to the complaint department. You may also leave a message on the State Medical Board of Ohio's Confidential Complaint Hotline at 1-833-333-SMBO (7626). Counselor Social Worker & Marriage and Family Therapist Board 77 S High St 24th Floor, Room 2468 Columbus, OH 43215 Phone: (614) 466-0912 Email: [email protected] |
Oregon
| If you have a concern or complaint about the mental health professionals providing care to you, you may contact a board agency to assist you. You understand that the provider may ask if you need more detail. ORS 17-52-677.07. All providers agree adhere to the Oregon Licensing Board's Code of Ethics set forth in OAR Chapter 833, Division 100. See Or. Admin. Rule 833-075-0050. You have the right: (A) To expect that a licensee or temporary practitioner has met the minimum qualifications of training and experience required by state law; (B) To examine public records maintained by the Board and to have the Board confirm credentials of a licensee or temporary practitioner; (C) To obtain a copy of the Code of Ethics (as indicated above); (D) To report complaints to the Board; (E) To be informed of the cost of professional services before receiving the services; (F) To be assured of privacy and confidentiality while receiving services as defined by rule or law. Licensees and temporary practitioners must include an explanation of each exception to confidentiality; and (G) To be free from being the object of discrimination on any basis listed in the Code of Ethics while receiving services. (e) Formal education and training, including title of highest relevant degree earned and school granting degree; (f) Oregon licensure requirements for continuing education and supervision; (g) Fee schedule; Additional information about this counselor or therapist is available on the Board’s website: www.oregon.gov/oblpct.” Or. Admin. Rule 833-075-0050.
| The Board of Licensed Professional Counselors and Therapists 3218 Pringle Rd SE, #120, Salem, OR 97302-6312 Telephone: (503) 378-5499 Email: [email protected] Website: www.oregon.gov/OBLPCT |
Rhode Island
| If you use e-mail or text-based technology to communicate with your provider, then you understand the types of transmissions that will be permitted and the circumstances when alternate forms of communication or office visits should be utilized. You have also discussed security measures, such as encryption of data, password protected screen savers and data files, or utilization of other reliable authentication techniques, as well as potential risks to privacy. You acknowledge that your failure to comply with this agreement may result in the telehealth provider terminating the relationship. Rhode Island Medical Board Guidelines.
| Rhode Island Board of Medical Licensure and Discipline Department of Health 3 Capitol Hill, Room 401 Providence, RI 02908 Phone: (401) 222-3855 Fax: (401) 222-2158 |
Pennsylvania
| You understand that you may be asked to confirm your consent to behavioral health or telepsychiatry services. 40 PS §1303.504(b). The information in this consent is required by the Board of Social Workers, Marriage and Family Therapists and Professional Counselors, which regulates marriage and family therapists and professional counselors. 63 PS § 1920.1.
| State Board of Social Workers, Marriage and Family Therapists and Professional Counselors P.O. Box 2649, Harrisburg, PA 17105-2649 717-783-1389 |
South Carolina
| The information you share in psychotherapy is protected health information and is generally considered confidential by both South Carolina state law and federal regulations, with some limited exceptions (e.g., may be shared with another healthcare provider, required by subpoena). Your mental health practitioner is also mandated by standards - through Duties to Warn - to breach confidentiality if: (1) you are threatening self-harm or suicide; (2) you are threatening to harm another or homicide; (3) a child has been or is being abused or neglected; and/or (4) a vulnerable adult has been or is being abused or neglected. S.C. Code 40-75-190. You understand your medical records may be distributed in accordance with applicable law and regulation to other treating health care practitioners. You understand the value having of having a primary care medical home and, if requested, we can provide assistance in identifying available options for a primary care medical home. S.C. Code Ann. § 40-47-37. You also understand that if you are a Medicaid beneficiary, you can withdraw your consent at any time. South Carolina Health and Human Svcs. Dept. Physicians Provider Manual, p. 35 (Feb. 2024).
| South Carolina Board of Examiners for The Licensure of Professional Counselors, Marriage and Family Therapists, and Psycho-educational Specialists P.O. Box 11329, Columbia, South Carolina 29211-1329 Telephone: 803-896-4652 |
South Dakota
| You have received disclosures regarding the delivery models and treatment methods or limitations. You have discussed with the telehealth provider the diagnosis and its evidentiary basis, and the risks and benefits of various treatment options. S.D. Codified Laws § 34-52-3.
| South Dakota Board of Medical & Osteopathic Examiners 101 N. Main Ave Suite 301 Sioux Falls, SD 57104 E-mail: [email protected] Phone: 605-367-7781 |
Tennessee
| You understand that you may request an in-person assessment before receiving a telehealth assessment if you are a telehealth recipient. TN Dept. of Mental Health and Substance Abuse Services. Office of Crisis Services Telecommunications Guidelines, p. 8, (2012) (Accessed Jan. 2024). The information you share in psychotherapy is protected health information and is generally considered confidential by both Tennessee state law and federal regulations, with some limited exceptions (e.g., may be shared with another healthcare provider, required by subpoena). Your mental health provider may also disclose information without consent: (1) if disclosure is necessary for other duties that the mental health provider is bound by, (2) if it is necessary to assure service or care is the least drastic means, (3) due to a court order, (4) if it is solely information to a residential service recipient, (5) to facilitate continuity of service to another health care provider, (6) if a custodial agent for another state agency that has legal custody of the service cannot perform the agent’s duties, or (7) it is necessary for the preparation of a post-mortem examination. Tenn. Code Ann. §33-3-105.
| Tennessee Department of Health 710 James Robertson Parkway Nashville, TN 37243 E-mail: [email protected] |
Texas
| You understand that your medical records may be sent to your primary care physician within 72 hours. Tex. Occ. Code Ann. § 111.005. You have been informed of the following notice: NOTICE CONCERNING COMPLAINTS -Complaints about physicians, as well as other licensees and registrants of the Texas Medical Board may be reported for investigation at the following address: Texas Medical Board, Attention: Investigations, 333 Guadalupe, Tower 3, Suite 610, P.O. Box 2018, MC-263, Austin, Texas 78768-2018, Assistance in filing a complaint is available by calling the following telephone number: 1-800-201-9353, For more information, please visit our website at www.tmb.state.tx.us You have been advised of the name, address and telephone number of the Council for the purpose of reporting violations. Tex. Admin. Code Rule § 681.35
| Texas Behavioral Health Executive Council George H.W. Bush State Office Building 1801 Congress Ave., Ste. 7.300 Austin, Texas 78701 Main Line (512) 305-7700 Investigations/Complaints 24-hour, toll-free system (800) 821-3205 |
Utah
| You are able to a (i) access, supplement, and amend your patient-provided personal health information; (ii) contact your provider for subsequent care; (iii) obtain upon request an electronic or hard copy of your medical record documenting the telemedicine services, including the informed consent provided; and (iv) request a transfer to another provider of your medical record documenting the telemedicine services. Utah Admin. Code r. 156-1-602.
| Utah Medical Board (801) 530-6628 (866) 275-3675 [email protected] Utah Division of Licensing, Behavioral Health Professions (Bureau 8) (801) 530-6628 (866) 275-3675 Toll-Free in Utah [email protected] |
Virginia
| You acknowledge that you have received details on security measures taken with the use of telemedicine services, such as encrypting date of service, password protected screen savers, encrypting data files, or utilizing other reliable authentication techniques, as well as potential risks to privacy notwithstanding such measures; You agree to hold harmless Backpack Healthcare for information lost due to technical failures; and you provide your express consent to forward patient-identifiable information to a third party. Virginia Board of Medicine Guidance Document 85-12. You have right to report to the Department if you believe the licensee, certificate holder, or registrant may have engaged in unethical, fraudulent, or unprofessional conduct. Va. Code § 54.1-3506.1.
| Virginia Department of Health Professions Enforcement Division Perimeter Center 9960 Mayland Drive, Suite 300 Henrico, VA 23233-1463 Telephone: 1-800-533-1560 or (804) 367-4691 Fax: (804) 212-2174 Email: [email protected] |
Vermont
| You understand that you have the right to receive a consult with a distant-site provider and will receive one upon request immediately or within a reasonable time after the results of the initial consult. You understand that receiving telehealth services via store-and-forward technologies by Backpack Healthcare does not preclude you from receiving real-time telemedicine or face-to-face services with the distant provider at a future date. Vt. Stat. Ann. § 9361. If you want to register a formal complaint about a physician, you should visit the medical board’s website, here. Board of Osteopathic Examiners can be found here. Vt. Board of Medical Practice, Policy on the Appropriate Use of Telemedicine Technologies in the Practice of Medicine (March 1, 2023). You have been provided with statutory definitions of unprofessional conduct (26 V.S.A. § 3016 and 3 V.S.A. § 129a). Vt. Admin. Code 20-4-1600: 6.8 [concerning psychologists] and Vt. Admin. Code 04-030-040:7.1 [concerning social workers]. The Board of Allied Mental Health Practitioners oversees all licensed mental health providers. If you either wish to make a consumer inquiry or, or file a complaint with this Board, your inquiry or complaint may be addressed to the Board at the Contact Information provided at the right. Vt. Admin. Code 20-4-1600: 6.8 [concerning psychologists] and Vt. Admin. Code 04-030-040:7.1 [concerning social workers].
| Consumers who have inquiries or wish to obtain a form to register a complaint regarding a professional counselor may do so by calling the Office of Professional Regulation at (802) 828-1505, or by writing to the Director of the Office, Secretary of State’s Office, 89 Main Street, 3rd Floor, Montpelier, VT 05620-3402. For physicians, see column to left. |
Washington
| You understand the purposes of and resources available to you surrounding this treatment, including the right to refuse treatment, and your responsibility in choosing a provider and treatment that best suits your needs. RCW 18.19.060. The information you share in psychotherapy is protected health information and is generally considered confidential by both Washington state law and federal regulations, with some limited exceptions (e.g., may be shared with another healthcare provider, required by subpoena). RCW 18.19.180. Counselors practicing counseling for a fee must be credentialed with the department of health for the protection of the public health and safety. Credentialing of an individual with the department of health does not include a recognition of any practice standards, nor necessarily imply the effectiveness of any treatment. The purpose of the Counselor Credentialing Act, chapter 18.19 RCW, is to: (A) Provide protection for public health and safety; and (B) Empower the citizens of the state of Washington by providing a complaint process against those counselors who would commit acts of unprofessional conduct. Patients have the right to choose counselors who best suit their needs and purposes. A copy of the acts of unprofessional conduct in RCW 18.130.180 can be found on the Washington State Legislature’s website at this address You understand that you are not liable for any fees or charges for services rendered prior to receipt of this consent. Wa. Admin. Code 246-810-031. You have been provided copy with a link to the acts of unprofessional conduct in RCW 18.130.180 and the name, address, and contact telephone number within the department of health for complaints. Wa. Admin. Code 246-810-031.
| Here is the name, address, and contact telephone number within the department of health for complaints. Washington State Department of Health Professions Quality Assurance P.O. Box 47865 Olympia, WA 98504-7865 (360) 236-4700 |
West Virginia
| Any questions, concerns, or complaints relating to the delivery of service by your provider, may be directed to the Board using the Contact Information to the right. This information is required by the Board of Examiners in Counseling which regulates all Licensed Counselors. W. Va. Code R. § 27-1-10
| West Virginia Board of Examiners in Counseling 815 Quarrier Street, Suite 212 Charleston, West Virginia 253 Phone: 1-800-520-3852 |
Wyoming
| Wyoming has implemented a privileged communication statute that states that, when involved in legal proceedings (civil, criminal or juvenile) patients retain the right to privacy, unless these specific circumstances exist: (a) abuse or harmful neglect of children, the elderly or disabled or incompetent individuals is known or reasonably suspected; (b) the validity of a will of a former patient is contested; (c) information related to counseling is necessary to defend against a malpractice action brought by a patient; (d) an immediate threat of physical violence against a readily identifiable victim is disclosed to the counselor; (e) in the context of civil commitment proceedings, where an immediate threat of self-inflicted harm is disclosed to the counselor; (f) the patient alleges mental or emotional damages in civil litigation or his/her mental or emotional state becomes an issue in any court proceeding concerning child custody or visitation; (g) patient or patient is examined pursuant to a court order; or (h) in the context of investigations and hearings brought by the patient and conducted by the board, where violations of this act are at issue. Providers will adhere to the Code of Ethics of the National Association of Social Workers; American Counseling Association; American Association of Marriage and Family Therapy; or National Association of Alcoholism and Drug Abuse Counselors, whichever is applicable for the provider’s profession. Wyo. Stat. Ann. § 33-38-113.
| Wyoming Mental Health Profession Licensing Board 2001 Capitol Ave, Room 105 Cheyenne, WY 82002 Tel: (307) 777-3628 Fax: (307) 777-3508 [email protected] |
