Confidentiality and Consent to Treatment
As mental health care providers, UCC staff are ethically and legally required to uphold standards of confidentiality. Students utilizing services at the UCC have a right to confidentiality and an expectation that their involvement with the UCC and information shared in the context of counseling will be protected. Confidentiality is very important to the success of the therapeutic process and UCC staff take it very seriously.
Counseling records are separate from a student’s academic records. Students must provide written permission to the UCC to request that information be shared with anyone on- or off-campus. In these instances, the UCC will share minimal information to coordinate care. Exceptions to student confidentiality can occur if a student poses an immediate risk to themselves or others; discloses abuse toward vulnerable populations (e.g., children and the elderly); or a court order is issued. Students are encouraged to discuss specific questions with their assigned counselor and may also call the UCC at 574-631-7336 for more information.
The UCC and University Health Services (UHS) operate as a team of health care professionals. By signing the Consent To Treatment form, students provide staff working in these departments with permission to consult with each other to provide the best care possible. These consultations are for treatment and/or professional training purposes only. Information will not be disclosed to any University department or outside agency beyond the UCC and UHS without a student’s written permission.
For students under the age of 18, Indiana law requires that a parent or guardian provide permission for mental health treatment services. The UCC will work directly with these students to obtain this consent.
A student’s UCC records are destroyed 7 years after the last date of service.
Consent to Treatment
The UCC works to be transparent regarding available services, and encourages students to take an active role in the counseling process. To that end, all students seeking services at the UCC are asked to read and sign an informed Consent to Treatment form.
This helps to protect individual rights and inform students about how the UCC works and what to expect in counseling. Students are asked to read and sign the consent to treatment form prior to receiving services. Reading this form in advance of seeking services for the first time can help to expedite a Drop-in appointment. Students who receive telehealth counseling are required to sign an additional consent form.
Release of Information
All treatment at the UCC is confidential. With a student’s written permission, in the form of a signed Release of Information Form (ROI), the UCC is able to share information about the student’s care with a specific person or agency, including a campus partner, off-campus provider, parent or guardian, etc. An ROI form includes the person to whom the information will be released, what information will be released, the purpose of the release, and an expiration date.
If there is a valid ROI form on file with the UCC, staff will be able to process a request to share information. If a request involves the coordination of care with a new provider, a new ROI form must be completed. If the ROI has expired it must be updated before information can be released. Students can retract an ROI form at any time by contacting the UCC. Please note that the UCC does not email clinical records. Please provide a fax number to ensure timely delivery of your records.
A blank ROI form as well as pre-populated ROI forms that are commonly utilized are provided below for your convenience. Simply download the ROI that you need, complete the form, sign it, and return a copy to the UCC.