• Grace Riddell, LICSW, LCSW-C and Associates

    griddell4@gmail.com | (202) 669-4379 | www.grace-riddell.com
  • DC Group Confidentiality Law

  • Confidentiality

  • Under the District of Columbia Mental Health Information Act of 1978 and the NASW Code of Ethics, any information regarding your psychotherapy is to be kept confidential. Several exceptions may apply: when you present an imminent risk of harming yourself or others, when the information you provide indicates evidence of child abuse or neglect, or in response to a court order in a judicial proceeding. In all other cases, I will not disclose information regarding your treatment unless I have obtained your written permission. If you are a minor between 14 and 18 years old, I must obtain the permission of your parent or guardian as well.

    I consult periodically with other mental health professionals to help maintain a balanced perspective and to improve the quality of my work. Although I may discuss case material related to your treatment during such consultations, I will avoid giving information that would reveal your identity.

    In order to create an environment of mutual trust, it is important that you also respect the confidences of other group members by not discussing their identities or concerns with anyone outside the group. The following notice is required by law:

    The unauthorized disclosure of mental health information violates the provisions of the District of Columbia Mental Health Information Act of 1989. Disclosures may only be made pursuant to a valid authorization by the client or as provided in Title III or IV of that act. The act provides for civil damages and criminal penalties for violations.

  • Signature

  • I have reviewed and agree with above mentioned agreement.

  • Signed by:*
  • Date*
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