Your information is confidential between you and your therapist. You may review or request a copy of your records at any time. We only release information with a signed Authorization to Release Healthcare Information from you or a court order. Please note: In the State of Washington, all clients age 13 and older are legally required to sign a release of information in order for mental health information to be shared.
Please read all information and instructions before completing and signing the authorization form. There may be a charge for copies of your records unless your records are being sent to another healthcare facility or a physician per Washington Administrative Code (WAC) 246-08-400.
Additional Information
Processing Time: In accordance with the Uniform Health Information Act for the State of Washington, records shall be released within fifteen days after receipt of a release form signed by all required parties.
Communicating by Fax: Many clients ask Storyline Counseling & Wellness to communicate by fax. It is our policy to use fax transmissions when necessary for treatment, payment or healthcare operations. By providing Storyline Counseling & Wellness with a fax number, you are consenting to Storyline Counseling’s use of that number for communicating with you by fax.
Client Rights: You have the right to revoke or cancel this authorization, in writing, at any time.
Cancellation Notice: Since records are usually handled within 2-3 days after receipt, Storyline Counseling and Wellness will not be held responsible for any release of records accomplished before receipt of a written notice of cancellation. Revocation takes place from the date of receipt of written request.
Instructions for Canceling a Request
You must provide a written request to Storyline Counseling and Wellness asking for revocation/cancellation of the original record release.
We need to have your complete name, date of birth, telephone number and the name of the person/agency that you authorized to receive the medical information.
After receipt of the notice, we will confirm and acknowledge your withdrawal of authorization via telephone.
If the release has been accomplished, you will be notified by a staff member. The release will be revoked for any further disclosure.
Washington State Record Retention Laws
Master Level Therapists (LMFT, LICSW, LMHC): WAC 246-809-035(4): The licensed counselor must keep all client records for a period of five years following the last visit. Within this five-year period, all records must be maintained safely, with properly limited access.