Teen Consent

Privacy of Information Shared in Bend Health Care:
Your Rights and Our Policies

What to expect:

The purpose of meeting with a care provider is to get help with problems in your life that are bothering you or that are keeping you from being successful in important areas of your life. You may be here because you wanted to talk to a coach or clinician about these problems. Or, you may be here because your parent, guardian, doctor or teacher had concerns about you. When you use Bend Health Services, we will discuss these problems and try to help. I It is important that you feel comfortable talking and sharing with us about the issues that are bothering you. Sometimes these issues will include things you don’t want your parents or guardians to know about. For most people, knowing that what they say will be kept private helps them feel more comfortable and have more trust. Privacy, also called confidentiality, is an important and necessary part of mental health care.

As a general rule, Bend Health will keep the information you share with us confidential in coach sessions, unless I have your consent to disclose certain information or they participate. In addition, they will have access to the upfront information collected for each visit submitted including assessment. There are, however, important exceptions to this rule that are important for you to understand before you share personal information with us. In some situations, our clinicians are required by law or by the guidelines of our clinician’s profession to disclose information whether or not we have your permission.

These include:

Confidentiality cannot be maintained when:

>You tell your clinician you plan to cause serious harm or death to yourself, and our clinicians believe you have the intent and ability to carry out this threat in the very near future. Our clinicians must take steps to inform a parent or guardian of what you have told us to make sure that you are protected from harming yourself.

> You tell your clinician you plan to cause serious harm or death to someone else who can be identified, and our clinicians believe you have the intent and ability to carry out this threat in the very near future. In this situation, our clinicians must inform your parent or guardian, and about the person who you intend to harm.

>You are doing things that could cause serious harm to you or someone else, even if you do not intend to harm yourself or another person. In these situations, our clinicians will need to use their professional judgment to decide whether a parent or guardian should be informed.

>You tell me you are being abused-physically, sexually or emotionally-or that you have been abused in the past. In this situation, our clinicians are required by law to report the abuse to the state’s Department of Social Services.

>You are involved in a court case and a request is made for information about your care. If this happens, our clinicians will not disclose information without your written agreement unless the court requires our clinicians to. Our clinicians will do what they can within the law to protect your confidentiality, and if they are required to disclose information to the court, they will inform you that this is happening.Communicating with your parent(s) or guardian(s):Our coaches and clinicians may believe that it is important for your parent(s) or guardian(s) to know what is going on in your life. In these situations, the coach or clinician will encourage you to tell your parent/guardian and will help you find the best way to tell them. Also, when meeting with your parents, our coaches and clinicians may sometimes describe problems in general terms, without using specifics, in order to help them know how to be more helpful to you.

[You should also know that, by law in many states, your parent/guardian has the right to see any written records.]

Communicating with other adults:

School: Bend Health will not share any information with your school unless we have your permission and permission from your parent or guardian. Sometimes our coaches and clinicians may request to speak to someone at your school to find out how things are going for you. Also, it may be helpful in some situations for our coaches and clinicians to give suggestions to your teacher or counselor at school. If they want to contact your school, or if someone at your school wants to contact Bend Health, we will ask for your written permission. A very unlikely situation might come up in which our coaches or clinicians do not have your permission but both our coach/clinician and your parent or guardian believe that it is very important for them to be able to share certain information with someone at your school. In this situation, our coaches/clinicians will use their professional judgment to decide whether to share any information.

Care team: Your doctor, nurse, therapists and coaches need to work together to get the best outcomes and so they will share information on the platform to make sure everyone is on the same page.