Release of Information – Frequently Asked Questions

A Release of Information is a form that must be completed for any protected health information (PHI) to be disclosed to any person or organization besides the client themselves. Mindful Therapy Group requires written authorization from the client prior to disclosing any protected health information (PHI).

Without a completed Release of Information, Mindful Therapy Group can not disclose any of your protected health information (PHI) to other parties. If you want another person to assist with scheduling your appointments, have someone else that you would like to pay your bills, or want someone to have access to your clinical records, you will need to complete a Release of Information giving them permission to access that information.

Without a signed Release of Information, Mindful Therapy Group can only disclose information directly to you, to third parties for coordination of payment (i.e. your insurance company), or to emergency services (in the event of an emergency).

You can choose to release your medical records to anyone. Most commonly a Release of Information is completed for family members, schools, or other providers/medical facilities.

Under state law, if your child is age 13+ (Washington) or age 14+ (Oregon), they are their decision maker for behavioral health treatment and will need to complete a Release of Information for any information to be disclosed to you. If your child has not completed a Release of Information, we will be unable to acknowledge that your child is a client of Mindful Therapy Group. This means that we cannot assist with scheduling, payments, or any other requests if you reach out on behalf of your child. For more information on Washington’s law, please refer to RCW 71.34.530. For more information on Oregon’s law, please refer to ORS 109.675.

Washington state law requires that when a client turns 13 that their record becomes private and only accessible by them. We will proactively reach out before a client turns 13 to ensure we have their contact information on file and that they understand the need to complete a Release of Information if they want their parent/guardian to continue to be involved in their care. It is the client’s decision once they turn 13 regarding what information they allow another party to have access to.

Unless otherwise specified, a completed Release of Information is valid for the duration of treatment with Mindful Therapy Group. Clients can select a specific expiration date or event that will terminate the ROI.

Written request is required to revoke a previously authorized Release of Information. Please complete and return the Revocation of Authorization for Release of Information form if you would like to revoke a previously authorized ROI. The requested revocation will not be effective until MTG confirms in writing that the revocation has been received and processed.