Confidentiality Agreement for Therapy Observations

Early Autism Services follows the respective regulations set by the Behavioral Analyst Certification Board’s (BACB) Professional and Ethical Compliance Code, American Speech Hearing Association's (ASHA) Code of Ethics, American Occupational Therapy Association's (AOTA) Code of Ethics and the Federal Health Insurance Portability and Accountability Act (HIPPA) to protect the confidentiality of medical and personal information of their clients. This information may not be disclosed except as authorized by law or as authorized by the client’s parent or legal guardian. These privacy laws and regulations apply to all individuals. This includes any individual who attends an observation of a therapy session within any setting. All observers are required to review and sign this confidentiality agreement.

Observers must have a signed and approved Confidentiality Agreement for Therapy Observations form filed prior to shadowing any therapy session. Observers must give their assigned BCBA/SLP/OT a 78-hour notice of the therapy session they would like to shadow. Observers must wear a Visitors badge given by the Receptionist at the front desk before entering any observation. Observers will refrain from addressing any therapist or interacting with the clients to avoid disruption to the learning environment. Observers will remain in the location they were directed to by the leading therapist so it does not disrupt the learning environment. If the Observer has specific questions or is seeking explanations about program or material information (i.e. individual progress, behavioral plans, visual supports, etc.), this should be completed outside the observation via follow-up conference, team meeting, phone call, email, etc. This is to avoid disruption to the learning environment and ensures the confidentiality of all clients. Observers cannot disclose any client identifying information that was witnessed during a therapy session to others. This includes but is not limited to, disclosing names, physical descriptions, their medical or therapeutic needs, etc. through oral statements or in writing.

I understand that, as an Observer, I may see, hear, or be exposed to confidential information about other clients, such as medical or personal information. I acknowledge that is my responsibility to respect the privacy and confidentiality of this information. I will not access, use, or disclose any confidential information outside of observations. I understand that Early Autism Services reserves the right to rescind my participation in therapy observations if any of the following guidelines are found in violation of this Agreement and/or I may be subjected to civil or criminal liability. If I have any questions concerning this Agreement, I shall direct them to the Clinical Director.