Confidentiality in the Counseling Relationship

Confidentiality is essential in any counseling relationship. In order to share private thoughts and feelings, it is vital that you know that what you say in your counseling sessions will be kept between you and your counselor.

There may be circumstances where your counselor may consult with or receive supervision from another member of our professional Student Center for Health & Counseling staff members. When doing so no identifying information will be discussed.

The Counseling Center does employ students. Student employees do not have access to client records and are required to be confidential and professional on all matters relating to the Counseling Center. Confidential records are handled only by professional staff.

Exceptions to Confidentiality

There are legal and ethical exceptions to confidentiality which require that the counselor take responsible action. They include:

  • When there is a clear and present danger of harm to yourself or another person. In these circumstances we are legally required to take action to protect your safety. Thus, our actions in these circumstances may include arranging for voluntary or involuntary hospitalization, as well as notifying law enforcement authorities and/or family/friends/individuals at risk.
  • In the case of suspected child abuse or abuse of a vulnerable adult. In these circumstances we are legally required to report the abuse to Child Protection Services or other appropriate county and/or state authorities.
  • In the event of a court order for information.
  • In the case of an emergency which poses a serious health threat to the client or another person(s).
  • When allowed or required under state or federal data privacy laws including the Minnesota Data Privacy Act, HIPPA or FERPA.

Medical Confidentiality

Confidential Medical Records

Records are maintained on each student/patient. All information is confidential and can be released with written permission or under special legal exceptions only. Records are maintained electronically and are accessible only by health service and counseling staff. Student employees have access to only the scheduling and demographic data in the record.

Release of Information

If you wish to have your medical or counseling records transferred, you may click on the link below to download a form. Once form is completed you can email it to, fax it to (218) 755-2750 or send it through the mail. Please Call (218) 755-2053 for any questions.

Release of Information form [PDF]

Notice of Privacy Practices

We will ask you to acknowledge receipt of the following information, please review it carefully.

This notice explains how the BSU Student Center for Health uses and discloses your personal health information and the rights that you, as a consumer, have to access this information and keep it private. We are required by federal and state law to protect the privacy of your personal health information and to provide you with this notice. If state law provides you with greater protection for your information or greater access to your records than the federal law, we will abide by state law.

Why Do We Ask You for This Information

We will use your personal information only to the extent necessary to conduct or support treatment, payment or other health care operations on your behalf or as authorized by you or by law.

Some examples are:

  • To tell you apart from other people with the same or similar name
  • To support treatment purposes such as care coordination and care management
  • To collect money from insurers or others, if they should pay for your care

Do You Have to Answer the Questions We Ask

Generally, the law does not say you have to give us the information.

What Will Happen if You Do Not Answer the Questions We Ask

We need the information to treat you, to receive payment for our services and to operate the administrative, financial, legal and quality improvement activities of our business. Without the information we may not be able to help you.

We Must Follow the Privacy Practices That Are Described in This Notice

We reserve the right to change our privacy practices and the terms of this notice. Before we make a significant change in our privacy practices, we will distribute a new notice to you and obtain your consent for new uses and disclosures, if required by law. To the extent applicable, any changes in our privacy policy will affect information we receive or create after the effective date of the new policy.

If You Have Questions About Anything You Read Here, Please Contact

BSU Student Center for Health and Counseling (SCHC), (218) 755-2053.

With Your Consent, as per Minnesota Data Privacy Practices

We can use your health information for the following purposes:

Treatment. “Treatment” generally means the provision, coordination or management of health care and related services among health providers or by a health care provider with a third party, consultation between health care providers or referral of a patient from one health care provider to another. For example, a doctor may use the information in your medical record to determine which treatment option, such as a drug or surgery, best addresses your health needs. The treatment selected will be documented in your medical record, so that other health care professionals can make informed decisions about your care. Under Minnesota law, we are required to obtain your written consent to disclose your personal health information outside SCHC.

Payment. In order for an insurance company to pay for your treatment, we must submit a bill that identifies you, your diagnosis and the treatment provided to you. As a result, we will pass such health information onto an insurer in order to help receive payment for your medical bills.

Health Care Operations. “Health care operations” include certain administrative, financial, legal and quality improvement activities necessary to run our business and support the core functions of treatment and payment. We may need your diagnosis, treatment and outcome information in order to improve the quality or cost of care we deliver. These quality and cost improvement activities may include evaluating the performance of your doctors, nurses and other health care professionals or examining the effectiveness of the treatment provided to you when compared to patients in similar situations. Under Minnesota law, we are required to obtain your written consent before disclosing your health record for these purposes.

Unless You Object

Unless you are incapacitated, we will give you an opportunity to Object to the following uses or disclosures of your information:

Family and Other Individuals Involved in Your Care – We may disclose to family members, friends and persons you indicate are involved with your care, personal information that is directly relevant to their involvement in your care.

Disaster Relief Efforts – We may release your health information to organizations authorized to handle disaster relief efforts so those who care for you can receive information about your location or health status.

Treatment Options -We may look at your medical information and decide to tell you about another treatment or a new service we offer.

Without Your Consent

In special circumstances specified in law, certain health information may be released to legal authorities, such as law enforcement officials, court officials or government agencies for specific purposes without seeking your permission. For example, we may have to report abuse, neglect, domestic violence or certain physical injuries or respond to a court order. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. The following provides more detail about such disclosures: *For public health activities. We may be required to report your health information to authorities to help prevent or control disease, injury or disability. This may include using your medical record to report certain diseases, injuries, birth or death information, information of concern to the Food and Drug Administration or information related to child abuse or neglect. We may also have to report to your employer certain work-related illnesses and injuries so that your workplace can be monitored for safety.

For health oversight activities. We may disclose your health information to authorities so they can monitor, investigate, inspect, discipline or license those who work in the health care system or for government benefit programs.

To respond to a court order or subpoena. We may have to disclose your health information as part of judicial or administrative proceedings.

For research. Under certain circumstances, and only after a special approval process, we may use and disclose your health information to help conduct research. Such research might try to find out whether a certain treatment is effective in curing an illness.

To avoid a serious threat to health or safety. As required by law and standards of ethical conduct, we may release your health information to the proper authorities if we believe, in good faith, that such release is necessary to prevent or minimize a serious and approaching threat to you or the public’s health or safety.

For workers’ compensation. We may disclose your health information to the appropriate persons in order to comply with the laws related to workers’ compensation or other similar programs. These programs may provide benefits for work-related injuries or illness.

Below is a listing of agencies and persons to whom we may release your health information for specific purposes:

  • Department of Commerce
  • Department of Employee Relation
  • Department of Health
  • Department of Human Services
  • Department of Labor & Industry
  • Department of Public Safety
  • Health Boards
  • Health professional licensing boards
  • Insurers/employers in workers comp
  • Law enforcement agencies
  • Local human services agencies
  • Medical examiners or coroners
  • Medical or scientific researcher
  • OCR/HHS Secretary
  • Potential victims of serious threats of physical violence
  • State Fire Marshall

Uses and Disclosures You Specifically Authorize

There may be times when we wish to use or disclose you personal information in a way that is not considered treatment, payment or health care operations or is not required by law. In those situations, we must get your specific written authorization to do so. If you sign an authorization form, we will use or disclose your Information as permitted by that authorization. You may withdraw your authorization at any time, except if we have already relied on it. If you wish to withdraw your authorization, please submit your written withdrawal. If you do not wish to authorize the proposed use or disclosure you may do so without fear of reprisal.

Your Health Information Rights

You have several rights with regard to your health information. Specifically, you have the right to:

  1. Inspect and copy your health information. With a very few exceptions, you have the right to inspect and obtain a copy of your health information. Please use the Release of Information form to make your request in writing. We will respond immediately or within 10 working days, unless an extension is necessary. If you request copies, we may charge you a reasonable fee as permitted by law. If we deny your request, you may be entitled to a review of that denial.
  2. Request to amend your health information. If you believe your health information is incorrect, you may ask us to correct the information. You may be asked to make such requests in writing and to give a reason as to why your health information should be changed. However, if we did not create the health information that you believe is incorrect or if we disagree with you and believe your health information is correct, we may deny your request. You may be entitled to a review of that denial. You may respond with a statement of disagreement to be included in your records.
  3. Request restrictions on certain uses and disclosures. You have the right to ask for certain restrictions on how your health information is used or to whom your information is disclosed, even if the restriction affects your treatment or our payment or health care operation activities. We are not required to agree in all circumstances to your requested restriction.
  4. As applicable, receive confidential communication of health information. You have the right to ask that we communicate your health information to you in different ways or places. For example, you may want us to contact you only at work or through a written letter sent to a private address. You must make your request in writing and specify how or where you wish to be contacted. We will accommodate reasonable requests.
  5. Receive a record of disclosures of your health information. You have the right to request and obtain a list of the disclosures we have made of your health information. This right does not apply to disclosures made to you or with your consent or authorization, for purposes of treatment, payment or health care operations and a few other limited exceptions. This list must include the date of each disclosure, who received the disclosed health information, a brief description of the health information disclosed and why the disclosure was made. We may not charge you for the list, unless you request such a list more than once per year.
  6. Obtain a paper copy of this notice. Upon your request, you may at any time receive a paper copy of this notice, even if you earlier agreed to receive this notice electronically.
  7. Complain. If you believe your privacy rights have been violated, you or your legal representative, may file a complaint with us or with the U.S. Department of Health and Human Services. We will not retaliate against you for filing such a complaint. To file a complaint with either entity:

Jennifer Fraik, Interim Director of The Student Center for Health and Counseling
1500 Birchmont Dr. NE, Box 42
Bemidji, MN 56601
(218) 755-2053

Office of Civil Rights Medical Privacy, Complaint Division
US Department of Health and Human Services
200 Independence Ave. SW
Washington,DC 20201
1-(866) 627-7748

Bemidji State University Student Center for Health and Counseling Services – Minor Consent for Treatment Form

Students under the age of 18 cannot be treated for health related services without consent. Exceptions to this are governed by Minnesota Statutes, Chapter 144. Please click on the link below to access our consent form. When you have completed the form you can fax it to (218) 755-2750 or mail it to the Student Center for Health and Counseling 1500 Birchmont Drive NE #42, Bemidji MN 56601

Minor Consent for Treatment Form