Your information is confidential between you and your therapist. You may review or request a copy of your records at any time. We only release information with a signed Authorization to Release Healthcare Information from you or a court order. Please note, in the State of Washington, all clients age 13 and older are legally required to sign a release of information in order for mental health information to be shared.

Please read all information and instructions before completing and signing the authorization form.  There may be a charge for copies of your records unless your copies are being sent to another healthcare facility or a physician per Washington Administrative Code (WAC) 246-08-400.

To receive an Authorization to Release Form or if you have any questions, please contact our Record Custodian at 425.869.2644, ext. 0.

Additional Information

  • Processing Time: In accordance with the Uniform Health Information Act for the State of Washington, records shall be released within fifteen days after receipt of a release form signed by all required parties.
  • Communicating by Fax: Many clients ask Emmaus Counseling Center to communicate by fax. It is our policy to use fax transmissions when necessary for treatment, payment or healthcare operations. By providing Emmaus Counseling Center with a fax number, you are consenting to Emmaus Counseling Center’s use of that number for communicating with you by fax.
  • Client Rights: You have the right to revoke or cancel this authorization, in writing, at any time.
  • Cancellation Notice: Since records are usually handled within 2 – 3 days after receipt, Emmaus Counseling Center will not be held responsible for any release of records accomplished before receipt of a written notice of cancellation. Revocation takes place from the date of receipt of written request.

Instructions for Canceling a Request

  • You must provide a written request to Emmaus Counseling Center’s Records Management Department asking for revocation/cancellation of the original record release.
  • We need to have your complete name, date-of-birth, telephone number (home/work) and the name of the person/agency that you authorized to receive the medical information.
  • After receipt of the notice, we will confirmation and acknowledge your withdrawal of authorization via telephone.
  • If the release has been accomplished, you will be notified by a staff member. The release will be revoked for any further disclosure.

Washington State Record Retention Laws

  • Master Level Therapists (LMFT, LICSW, LMHC):  WAC 246-809-035 (4): The licensed counselor must keep all client records for a period of five years following the last visit. Within this five-year period, all records must be maintained safely, with properly limited access.
  • Psychologists (Ph.D.): WAC 246-924-354 (2): All records must be retained for at least eight years following the last professional contact with the client(s). In the case of minors under the age of eighteen, the records must be retained until the client reaches the age of twenty-two or for eight years, whichever is longer. All records must be securely maintained with appropriate limited access in accordance with any other applicable state or federal laws.