Electronic Privacy Notice

Explorer 2 Counseling Center will have clients sign a communication agreement in their 1st session.  Please read this content to understand your rights and limitations of electronic communications.  Therapists can assist you with questions and concerns.

Name:_________________________ Phone Number:_______________________

E-mail address:____________________________________________________________

⃝    By submitting this form you agree to receive text messages from Explorer 2 Counseling Center LLC.

RISKS OF USING EMAIL/TEXTING

The transmission of client information by email and/or texting has a number of risks that clients must consider prior to the use of sending or receiving email and/or texts. These include, but are not limited to, the following:

· Email and texts can be circulated, forwarded, stored electronically and on paper, and broadcast to unintended recipients.

· Email and text senders can easily misaddress an email or text message and send the information to an undesired recipient.

· Backup copies of emails and texts may exist even after the sender and/or the recipient has deleted his or her copy.

· Employers and on-line services have a right to inspect emails sent through their company systems.

· Emails and text messages can be intercepted, altered, forwarded or used without authorization or detection.

· Email and texts can be used as evidence in court proceedings.

· Emails and texts may not be secure and therefore it is possible that the confidentiality of such communications may be breached by 3rdparties.

CONDITIONS FOR THE USE OF EMAIL AND TEXTING

Therapists cannot guarantee but will use reasonable means to maintain security and confidentiality of email and text information sent and received. Therapists are not liable for improper disclosure of confidential information that is not caused by the therapist’s intentional misconduct. Clients/Parent’s/Legal Guardians must acknowledge and consent to the following conditions:

· Email and texting is not appropriate for urgent or emergency situations. Provider cannot guarantee that any particular email and/or text will be read and responded to in an appropriate and timely manner for emergency situations.

· Email and/or texts should be used for scheduling appointments or to alert therapists of a need for a phone or video discussion for complex or sensitive situations.

· Please discuss with your therapist details regarding call return expectations.

· You may opt out of receiving text messages at any time via writing.

Explorer 2 Counseling Center will not share, sell or rent any contact information and/or SMS consent with third parties.