Andrea Chaitin-Richards, MA, LCPC
CONSENT TO COMMUNICATE BY
E-MAIL
E-mail is not a
secure form of communication. I understand that if I choose to
communicate with the psychologist by e-mail, the confidentiality of any
e-mailed information cannot be ensured.
If I send an e-mail to
the psychologist, I understand that the confidentiality of that e-mail
cannot be ensured. If I ask for a response from the psychologist and
give the psychologist my e-mail address, I am granting my consent for
the psychologist to respond to me by e-mail, unless I request that a
response be made by another means that I specify in my e-mail to the
psychologist.
I acknowledge that I have read the statements above
regarding the security of e-mail communication between me and the
psychologist and I consent to communication by use of e-mail.