Release of Information Form

Electronic modes of communication are not necessarily secure and can put your privacy at risk.

Following is Gateway Recovery Center’s policy on electronic communication. Should you have any questions, please feel free to discuss them with a staff member at any time.

Email Communications:

Email is not a secure form of communication. We use email communication for administrative purposes, forms and consents and appointment reminders, unless we have made another agreement. If you choose to email us about clinical matters and request or expect a clinical response, it is at your own risk. Ideally clinical matters should wait to be discussed at your next session or over the telephone. Email communication is also used to send links for the review and signing of electronic consent and intake forms, and by entering your email in any form on our website you are accepting responsibility for the management of any information sent via unsecure email. Please do not enter your email in this form if others have access to your email account, or if you do not want protected health information sent via email communication. 

Text Communications

Text messaging is a very unsecure mode of communication. Should you consent, we will use text messaging to send regular appointment reminders, to cancel a session at the last minute, or communicate about other more time-sensitive matters. We might also text to alert you to an email that we’ve sent that is time-sensitive. If you choose to text us, be aware that text lines are not constantly monitored and you may not get a reply expeditiously. Texting should be limited to appointment and administrative issues, and should not contain clinical content. By entering your phone number into this form, you are consenting to receive text messages for the purposes defined in this section.