Intensive Outpatient Program or other Group Therapy Notes

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

RELEASE FORMS

Most institutions prefer that you use their own release forms. You may be able to download a form from the facility’s website if they have one, or you can call the hospital’s medical records department (sometimes called Health Information Management) and ask about the records release procedure.

Please ask the facility to send the records directly to my office. 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 the production of a record taints the file and can require us to start over.

This is what counts as a full treatment record:

  • Counselor’s intake summary
  • Psychosocial assessment
  • All individual counseling notes
  • Any physician notes and orders
  • De-identified group therapy notes
  • All laboratory testing data, including sobriety testing
  • Psychological reports, if any
  • Counselor’s discharge summary, if any
  • Substance use/abuse assessment, if any

There are two 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: can be slower than email, especially for larger files
  • Note: large files can also be sent by flash drives or DVDs in regular US mail

By secure email to gregkirk@avipsy-secure.org

  • Pros: immediate transfer of files smaller than 25 MB
  • Cons: security protocols don’t always integrate well across systems, and an incoming mail might be blocked/quarantined without me knowing.

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.

HIPAA rules gives special protections to psychotherapy records. Among the protections is that a psychiatrist 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 doctor might have, please know that:

  • 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 psychiatric summary letter, which by rule highlights some content and excludes other information, unwittingly places your treating doctor as a decision maker in an  aeromedical 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 psychiatrist asks that I not release the file to you, in order to preserve the therapeutic alliance between the two of you, 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.