Collection and Sharing of Personal Information
Personal information will be collected during assessment and treatment. This information could include identifying information (e.g., name, contact information), test results, reports, progress notes, payment information, and any information collected with your permission from other health care providers. Our records are kept secure in a confidential electronic file and in accordance with legislative health privacy guidelines. Records are kept for a minimum period of 10 years or 10 years past your child’s 18th birthday if your child is a minor at the start of assessment or treatment. You have the right to obtain copies of your file or your child’s file (if under 18 years of age at time of request). All file requests are subject to an administrative fee.
Your consent allows us to share information with all experts involved in assessment and treatment within our Multidisciplinary Care Team. Your information will also be shared with our Administrative Team for booking, billing, and other administrative purposes.
Your consent also allows us to share information with your referring physician in the community. However, if you would like us to send information, including Assessment Reports, to anyone else outside of the clinic, your written consent on a separate form, authorizing release of information, will be required.
Through the use of standardized tests, measures, and interviews, we will attempt to answer the questions that have brought you to Possibilities for assessment. Once we review the information and results acquired during the assessment, a report will be written detailing findings and our interpretations and recommendations. You will have the opportunity to meet to discuss the results, interpretations and recommendations with members of our Assessment Team. You will also receive a copy of the report.
The treatment process generally involves an initial intake session with the patient or, in the case of children and adolescents, with parents or legal guardians. At the end of the initial intake session, type of treatment, treatment goals, and frequency and duration of sessions can be determined. For treatment with children and adolescents, some treatments involve working with parents directly, some involve working with children and teens directly, and some involve a combination, working with all members of the family together or in separate sessions.
Possible Risks, Discomforts, and Benefits of Assessments and Treatments
Your consent indicates that you understand the purpose of the assessment or treatment that you are seeking for yourself and/or your child or adolescent. Assessment and treatments are designed to benefit your daily functioning and support positive outcomes. In the course of an assessment or treatment, interview questions may touch on personal and private matters that could revive painful memories. Your consent implies that you recognize that clinicians and interventionists who carry out assessments and/or treatments with you, your child, or your adolescent have no intention of causing any personal discomfort, but are performing professional tasks that are typical and reasonable for the assessment and/or treatment being pursued. For some individuals, participation in an assessment or treatment may cause temporary fatigue, physical discomfort, frustration, and/or stress. Our staff will do everything reasonable to minimize any such discomfort.
If medications are recommended and prescribed as part of a treatment plan, verbal consent will be obtained after the risks and benefits of the medication treatment plan have been discussed, and prior to initiation of treatment.
Limits of Confidentiality
Your referring physician will receive assessment reports and treatment information as part of your circle of care. Beyond your referring physician, information contained within your clinical record cannot be released outside of the Possibilities Clinic without your written permission, except as required by law. Exceptions where information must be released include:
Situations where you are a danger to yourself or others
If there are grounds for apparent, suspected, or potential child abuse
If there are grounds for apparent, suspected, or potential elder abuse if living in a long-term care or retirement facility
If you report sexual abuse by a healthcare professional
If information is subpoenaed by a court
If your file is subject to a review process by licensed peers or a professional licensing body in accordance with Regulatory Professional Colleges
Teaching Facility Specifics
The Possibilities Clinic serves as a teaching facility for individuals in training in all professional specialties represented at our Clinic. As such, some assessment, diagnostic and treatment procedures you or your family receive may involve a medical resident, a practicum student, a graduate intern, a post-graduate clinician working towards professional licensure, or a trainee in psychometry and associated interventions. In all cases, individuals in training are working under the direction and supervision of licensed physicians and/or allied health professionals at the clinic. Prior to any session, you will be informed of an individual’s training status and the name of their direct clinical supervisor. In cases where an individual in training is observing a clinical session or performing clinical functions, you retain the right to decline the involvement of the trainee.
Multidisciplinary Team Process
At Possibilities, we offer a unique team approach to diagnosis and treatment. For clients, multiple clinicians from different disciplines form Core Diagnostic and Treatment Teams. Gathering data, reviewing information, measuring skills, making diagnostic decisions, and formulating treatment recommendations are done by each client’s Core Team members. In addition, the Core Team consults additional clinicians at Possibilities—also from multiple disciplines—for additional data review and recommendations during Clinic Rounds before diagnostic and treatment recommendations are finalized and prioritized to support success. Clinicians on the client’s Core Team, as well as additional clinicians consulted during Clinic Rounds, all adhere to standards of confidentiality regarding client information, diagnoses, and treatments.
Our Adherence to Guidelines and Protocols
Assessments at Possibilities follow specific testing protocols, whether they are conducted in person or through secure video sessions. Guidelines for video testing were created based on recommendations from professional consultations, and education provided by licensed clinicians, researchers, and test developers experienced in the provision of video testing and knowledgeable about research supporting the effectiveness of this approach. Research guidelines from published studies on remote testing were also consulted. Measures taken in our video assessments following suggested protocols include, but are not limited to, 1) explaining to parents/guardians their role as facilitators in ways that support technological solutions while preserving the validity of child responses, 2) using shared screens to present testing stimuli, 3) when indicated, sending paper response booklets in sealed envelopes that remain unopened until the examiner indicates they are needed, and 4) having clients seal envelopes on camera after a paper protocol is completed. Our adherence to guidelines and protocols for video testing supports the validity and reliability of the data we collect across assessment sessions. Additional testing guidelines were followed based on Possibilities Clinic Multidisciplinary Team Assessment protocols, specifications outlined in standardized test manuals, and in accordance with professional training in test administration.
Declaration and Consent
I have read this consent from, understand its contents, and agree to its terms for assessment and/or treatment. Furthermore:
I understand that consent is an ongoing process and that I can ask to revisit this continued consent at any point in time in the assessment or treatment sessions.
I understand that I have the right to stop the assessment and/or treatment process at any time.
I understand that if I am unable to relay, or do not provide relevant background and health information, this omission may affect the completeness and accuracy of assessment conclusions and any diagnoses made, as well as the effectiveness and safety of treatment.