Electronic Health Records: GAUNUM with ADE Incorporated is the electronic client portal for your clinical evaluation. You will be able to provide and receive information
as well as communicate through a private online server. The server meets the Health Insurance Portability and Accountability Act (HIPAA
1996) and HITECH requirements. This portal is part of my personal, professional, and legal obligation to keep all your Protected Health
Information (PHI) confidential and secure. Every health care provider, regardless of size, who electronically transmits health information in
connection with certain transactions, is a covered entity; therefore, required to meet HIPAA and HITECH standards.
If you have an electronic device that can connect to the internet and receive email or text messages, you can register an account and have
access to your shared protected health records. You will receive a Welcome message at your specified email address or phone number (with
internet enabled messaging). This allows you to secure your account by setting your own password and answering security questions. Your
client portal will allow you to communicate with your evaluator, to receive copies of shared documents, contracts, receipts, upload required
collateral information, sign release of information and more. If you do not have a device available, your evaluator can provide copies of physical
documents for your records or signature. You are responsible for protecting your physical electronic device, email, password and security
questions.
Business Associates: I understand and agree that software provider ADE Incorporated performs functions or activities on behalf of, or
provides certain services to, all interested participants with my case that involve access by the business associate to protected health
information. ADE Incorporated may use or disclose protected health information only as permitted or required by its business associate contract
or as required by law.
Social Media Policy (SMP): Facebook, LinkedIn, Instagram, Pinterest, Twitter, etc. We may have public social media accounts or blog. Our
SMP is not to accept or communicate with current or former clients on our social media pages. Our policy is not to search client names through
Google or any other search engine. We respect your privacy and make it a policy to allow you to share the information you choose with us. If
there is something public about you on the internet and you want to discuss it, please print and bring it with you to your session. We may write a
blog or post relevant counseling or psychology new on our media pages. If you have an interest in following any of these, please let your
counselor know so he/she may discuss any potential implications to your therapeutic relationship. Technology is constantly changing and even
though your confidentiality is a priority, there may be implications not recognized at this time. We do not respond to clients through social media
messaging and recommend you only contact us through the official office phone number or though Unum. If you choose, you can follow our
pages or post; however, we recommend you use and an alias to protect your anonymity. If you are concerned about your anonymity, please do
not engage with us on social media. In general, social media or social networking sites IE Facebook, Twitter and others are not private and
may comprise your confidentiality.
Photo or identifiable image: You may have my photo or photo identification to be part of my patient health record. The purpose is for your
identification to be attached to Patient Health Record (PHR) and included in the Designated Record Set (DRS) shared after individual releases
o f information are signed. This means any DRS you choose to share will include your photo or identifiable image on documents. These
documents can only be shared with you written approval.
Additional files: Your evaluator may request additional documentation. You may upload these documents into your client portal. Since these
are your documents, you are responsible for their security while they are in your possession. Once they are part of your PHI, your provider will
secure them as required to meet HIPAA/HITECH requirements. HIPAA (https://goo.gl/embpCU) HITECH (https://goo.gl/EDC44W) You will be
responsible for the files in your possession.
Privacy and Confidentiality Statement: With HIPAA requirements, additional above stated laws and regulations and other considerations,
this portal provides easy and secure communication for you, the health care provider/clinical evaluator and others you want to share information
with such as a family member, additional medical provider or for legal purposes. The law protects the privacy of communication between a
client and a clinical evaluator/treatment provider or counselor. In most situations, we can only release information about your referral to others
with a written authorization form that meets certain legal requirements imposed by HIPAA (health Insurance Privacy Act of 1996). Your
information will remain confidential with your provider unless you sign a written statement allowing the provider to release your information to a
specific person/entity. The release can be voided by the client unless action has already been taken. Disclosures without your consent include:
mandated reporting of physical or sexual abuse of children, threats of suicide or homicide, information necessary for supervision or
consultation, client files a complaint, in case of an emergency or crisis, client files worker’s compensation claim, collection of fees,
government agency requests information for health oversight, if court ordered by law, information released as outline in the HIPAA Notice of
Privacy Practice or CFR 42, and those required by law. To protect your electronic health records, we recommend you communicate through the
client portal: https://gaunum.com. We cannot totally guarantee someone other than yourself will gain access to your account especially if they
have your electronic device, your username and password. However, communicating outside of the portal through other less secure means
such as email, fax, or text is not recommended. If you want us to communicate outside of the client portal, please provide the ways which are
best for you in writing. Ask your provider to go over options and agree to terms.