- If you are a health care provider serving or seeking health information from a person who has experienced domestic violence, sexual assault, or stalking, these frequently asked questions will help you:
- Understand the safety and privacy concerns the person may have with sharing his/her health care information with another care provider.
- Speak with the person about these concerns.
- Identify the proper form for obtaining the person’s permission to share information about behavioral or mental health services, referrals and/or treatment for substance use disorders, or communicable diseases.
- Identify referral resources for people who need information about and support for domestic violence, sexual assault, or stalking.
To learn more about domestic violence prevention and services, visit www.michigan.gov/domesticviolence.
To learn more about health information sharing, visit www.michigan.gov/bhconsent.
Domestic Violence, Sexual Assault, and/or Stalking - Health Information Sharing for Professionals
- When should health care providers use the standard consent form (DCH-3927) for release of specially-protected health information? When must a separate form be used?
- Is there a standard separate form? What does a separate form look like?
- Not all of the people I serve are receiving services for domestic violence, sexual assault, or stalking. Can I use the standard consent form (DCH-3927) for these individuals?
- Why is a separate consent form needed to release specially-protected health information for individuals receiving services for domestic violence, sexual assault, or stalking?
- What's the difference between the standard consent form developed by the Department under Public Act 129 of 2014 (DCH-3927) and the separate form I should use if I provided services for domestic violence, sexual assault, and/or stalking?
- What should I do if I provided services for domestic violence, sexual assault, and/or stalking and the standard consent form (DCH-3927) isn't right for the person who received these services?
- What should I do if I provided someone with services for domestic violence, sexual assault and/or stalking, and I receive a standard consent form (DCH-3927) from another provider that this person has signed?
- What are referral resources for individuals who have experienced domestic violence, sexual assault, and/or stalking and need additional assistance?
- What should I do if the person I am serving is in immediate danger?
