Counseling Records

WHERE DO YOU SEND RECORDS?

Dr. Kirk has offices in Denver and Las Vegas. Denver is the main clinic and Las Vegas is a satellite location. All records should be sent to:

Aviation Psychiatry, LLC
Gregory L. Kirk, MD
2036 East 17th Avenue
Denver, Colorado, 80206

or by email to

gregkirk@avipsy-secure.org

 
The rest of this page is your personal guide to smoothly coordinate the records transfer needed for an evaluation. You can also share with the page with your therapist if you want.
 

RELEASE FORMS

Most clinics prefer that you use their own release forms. You may be able to download a form from the clinic website, if they have one, or you can call the clinic and ask about the records release procedure.

Please ask your therapist to send the records to my Denver office, even if our appointment will be in Las Vegas.

If a file instead comes to you by mistake, do not open the envelope but instead deliver it to me unopened. A broken seal on a records production taints the file and can require us to start over.

You should request the complete record of care, which includes ALL notes of these types:

  • Individual counseling notes, including psychotherapy notes
  • Psychological test results and reports, if any
  • Notes that include any and all information about the use of drugs or alcohol
  • Intake assessment notes

There are three ways to have records sent to me. Each has pros and cons.

By US Mail: (note — all mail comes to Denver even if we meet in Las Vegas)

  • Pros: regular mail is HIPAA compliant
  • Cons: the US mail since June 2020 has operated under workplace rules that cause delay of regular mail delivery

By secure email to gregkirk@avipsy-secure.org

  • Pros: immediate transfer of files smaller than 25 MB
  • Cons: the least secure way to transfer files (but gregkirk@avipsy-secure.org uses a fully HIPAA-compliant HIPAA ProtonMail server)
  • Cons: security protocols don’t always integrate well across systems, and an incoming mail might be blocked/quarantined without me knowing.

By media transfer (DVDs, portable USB devices): (reminder– all mail comes to Denver even if we meet in Las Vegas)

  • Pros: the best way to transfer large amounts of information > 25 MB
  • Cons: still relies on the US Mail

WHY DO WE NEED THE RECORDS, ISN’T A CLINICAL SUMMARY GOOD ENOUGH?

In the FAA Specification Sheet for a psychiatric examination, one of the core duties that the aviation psychiatrist must complete is

A review of all available records, including academic records, records of prior psychiatric hospitalizations, and records of periods of observation or treatment (e.g., psychiatrist, psychologist, social worker, counselor, or neuropsychologist treatment notes). Records must be in sufficient detail to permit a clear evaluation of the nature and extent of any previous mental disorders.

WHAT HIPAA SAYS ABOUT THERAPY NOTES

HIPAA rules gives special protections to psychotherapy records. Among the protections is that a therapist can refuse to release a psychotherapy file, without giving you a reason, unless a valid court order compels a release of the record. To address a few common concerns you or your therapist might have, please know that:

  • The FAA advisory, stated above, specifically says that the psychiatrist must review treatment notes (not summaries) from your counseling provider.
  • A summary of treatment, whether by a letter or phone call, most of the time fails to meet the  “sufficient detail” standard as described in the FAA’s specification sheet.
  • A therapist’s summary letter, which by definition as a summary of a record, highlights some content and excludes other information, unwittingly places the therapist as a decision maker in a public safety assessment.
  • By contrast, releasing the file without restrictions keeps the responsibility for aeromedical safety assessments focused on the aviation psychiatrist.
  • The records have the same HIPAA psychotherapy protections when held in this office as when kept by the originator. The file can be released only with your written consent or a court order. If your therapist asks that I not release the file to you, in order to preserve the therapeutic alliance between you and your therapist, I have an ethical obligation to honor that request and would not release the file to you without a court order.
  • I also have an ethical obligation to de-identify my report so that the assessment does not reveal protected health information (PHI) of others. For example, I am not allowed to quote something from the psychotherapy record that inadvertently identifies any other person, such as a spouse, child, or companion.