Why is a separate consent form needed to release specially-protected health information for individuals receiving services for domestic violence, sexual assault, or stalking?

Confidentiality is essential to providing meaningful health care services for individuals who have experienced domestic violence, sexual assault, or stalking. If confidentiality is not assured, fear of the consequences of disclosure may cause these individuals to withhold critical information, or prevent them from seeking supportive services and/or treatment. Some possible adverse consequences from disclosure include:

  • For individuals in hiding from abuse perpetrators, disclosure of locating information can result in serious injury or death at the hands of the perpetrator. For these individuals, even the disclosure of a service provider’s location or the time and date of appointments can be clues that provide perpetrators access to their targets.
  • Some perpetrators threaten serious or lethal harm to their targets or to other people who are important to their targets in retaliation for disclosures of abuse. Information on an insurance form, billing statement, or other health care record that a target has consulted with a provider may result in retaliatory violence, particularly if the provider can be identified as an expert in domestic violence, sexual assault, or stalking.
  • A perpetrator who learns that a target has sought health care may subpoena the provider’s records in the context of a court case. Information in the records may be used to prejudice the target in a child custody dispute, or child protective proceeding, or to damage the target’s credibility as a witness against the perpetrator in a criminal case.
  • A perpetrator may use the fact that a target has sought health care to embarrass or humiliate the target in front of supportive friends, family members, or faith community members, or to create doubts about the target as a prospective employee or tenant.

To address the heightened safety and privacy concerns for individuals who have experienced domestic violence, sexual assault or stalking, care providers receiving funding under the federal Violence Against Women Act (VAWA) and Family Violence Prevention and Services Act (FVPSA) must follow strict requirements for obtaining consent to release health information. Although the VAWA and FVPSA requirements apply only to funded care providers, all providers are encouraged to follow them, because they describe best practices to promote safety regardless of how the provider is funded. The National Network to End Domestic Violence has developed a sample form that meets the VAWA and FVPSA requirements (available in English and Spanish).

As a final note, abuse perpetrators seeking to locate or harm a target individual may use coercive, manipulative, or fraudulent means to obtain the information needed to carry out their intent. In addition to ensuring that individuals’ sensitive health information is protected, health care providers should also be alert to signs that an individual’s consent to disclose that information is not voluntarily and willingly given.