Records Release Process

Counseling and Psychiatry Records: What you Need to Know

Cook Counseling Center values the privacy of its clients and the confidentiality of the personal health information entrusted to us. Your counseling and/or psychiatry records are kept confidential at all times and are not associated with your academic record. We maintain confidentiality in accordance with HIPAA medical standards and our accrediting body, IACS. Records are retained for a period of 6 years following the last clinical appointment/clinical contact at Cook Counseling Center.

If you need to obtain a copy of your counseling and/or psychiatry records, you may request one by the process outlined below. Partial records are not released with the exception of requests for the first and last psychiatric evaluation. Charges for records are $10 or $20 and can be one of the following:

• Appointment dates: $10
• Treatment summary: $20

Note: If release is requested by a provider to a provider for continuation of care, there is no cost.

These fees are due upon request of the copy, and records will not be released until payment has been confirmed. Please allow 2 weeks to process your request after payment is received.

To obtain a copy of your records, please follow this process:

1. Print, complete, and sign a copy of the Release of Information form.
2. Submit this to the front desk at Cook Counseling either in person, or via fax to 540-231-2104 (if via fax, please include a copy of your driver’s license).
3. Front desk staff will request a link for payment to be sent to you, and payment must be made via credit card.
4. Once payment is confirmed, you will be contacted when records are ready for pick up.