• Home
  • Services
  • Meet Your Team at APNSolutions, LLC
    • MEET Dr Laura G Leahy, DrNP, APN, FAANP, FAAN
    • MEET Courtney Seidenberg, MSN, APN
    • MEET Alison “Ali” Prudente, MSN, APN
  • Publications
  • Getting Started
    • Appointment Request
  • Rates and Insurance
  • Contact
    • Appointment Request
    • Office Location
    • Office Hours
  • Resources
    • Patient Forms
    • Recent News
    • Mental Health Links
    • Physical Health Links
    • FAQs
logo

(856) 556-0860 | LGLeahy@APNSolutions.com

  • Facebook
  • LinkedIn
  • Twitter

APNSolutions, LLC

My WordPress Blog

Patient Forms

Please understand that APNSolutions takes your privacy and confidentiality very seriously and has made every effort to maintain the security of your treatment records. As you are aware, the law protects the relationship between a patient and a psychiatric mental health practitioner and, with few exceptions, information cannot be disclosed without the patient’s written permission.  Adolescents age 14 and older have the same right to the privacy and confidentiality of their psychiatric mental health & substance abuse treatment records and must also give written permission for information to be released, even to their parents or guardians.

There are very few scenarios in which a patient’s confidentiality and privacy may be broken without the patient’s written permission for disclosure.  These exceptions for which a patient’s confidentiality and privacy may be broken are listed below:

  • The clinician suspects child abuse or neglect or dependent adult or elder abuse. Under these conditions the law requires that the clinician immediately report the suspicions to the appropriate authorities.
  • If a patient is threatening serious bodily harm to another person/s, by law, the clinician must notify the police and inform the intended victim.
  • If a patient threatens or intends to harm himself or herself, the clinician will make every effort to enlist their cooperation in maintaining their safety. If the patient does not or is not able to cooperate, the law allows the clinician to break confidentiality and privacy in order to take measures to ensure the patient’s safety.

The following forms are a review of our confidentiality limitations and HIPAA Privacy Notices.

  • HIPAA Privacy Notices
  • Limits of Confidentiality/Cancellation Policy

If you would like us to coordinate care with another provider (for example: a family member, your previous Psychiatrist or Psychiatric Nurse Practitioner, a therapist, your primary care practitioner, etc.), complete the Release of Information Form by to authorize release of psychotherapy information:

  • Release of Information Form

In an effort to improve the safety and security of our citizens and reduce the impact of improper medication disposal on our environment, the New Jersey Division of Consumer Affairs has issued guidelines for the Safe Disposal of Medications.  Please click on the following link to review this important information:

  • Project Medication Drop
  • Safe Medication Disposal Flyer

 

123 Egg Harbor Rd Suite 703
Sewell, NJ 08080

(856) 556-0860
LGLeahy@APNSolutions.com

By submitting this form via this web portal, you acknowledge and accept the risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means.

Privacy Policy

A Therapist Website by Brighter Vision