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Informed Consent

Marlboro College Total Health Center Counseling and Medical Care Policy

This document is intended to give you information about the services we provide, policies and procedures we follow, what you can expect from your counselor or medical provider, and what we ask of you. If you have any questions after reading this information, we encourage you to discuss them with any member of our staff. He or she will be happy to answer any questions you may have. When you have read and understood this policy, please sign the last page. This will remain in your confidential file at the Total Health Center.


We are personally, professionally, and legally committed to your right to privacy. What is discussed with your provider will remain confidential within the Total Health Center. This information will not be disclosed without your written consent except as permitted by law.

For example:

  • We may disclose information to the appropriate authorities- the police, Residential Life, the Dean of Students and/or family members or emergency contacts, if it is a matter of saving your life, keeping you from harming yourself, or if you have broken the law.
  • We must warn the victim or police if a counselor or medical provider knows of a client’s threat to harm another person or property.
  • We must report current child or elder abuse.
  • We must disclose information requested pursuant to valid court orders.
  • We must report to the appropriate professional associations and licensing boards if a student reveals any unethical behavior by a provider.


Your records do not leave the Health Center. Records are maintained in locked cabinets and a secured database. We do keep statistics on our services and include them in our semi-annual reports; however, individuals are not identified.


In order to provide you with the best services possible, and for purposes of consultation, supervision, or referral, we may discuss or review information about a client with fellow staff members. The Total Health Center endorses a model of total wellness. We wish to deliver the best comprehensive services possible. The counseling and medical offices often consult and work together to meet the individual’s emotional and physical needs.

Limitations of Treatment

Should you require services that the Total Health Center does not provide, you will be referred to another agency or treatment provider that can meet your needs. Examples of the kinds of services not offered at the Total Health Center are treatment for severe psychological disorders, court-mandated treatment, and medical issues requiring specialists.

Our Responsibilities

We all subscribe to the ethical standards of our own professions. These require that we safeguard information about you, refrain from role conflicts such as business arrangements or intimate, social and/or sexual relations; follow appropriate and acceptable diagnostic and treatment practices within our levels of expertise and competence; and protect the welfare and dignity of all the people we serve.

The Center is staffed by professionally trained providers and counseling interns. Experienced professional counselors supervise and oversee the work of our counseling interns. If you are working with an intern you may be asked to agree to have a session tape recorded so that the supervisor can better evaluate and supervise the intern. You are free to decline a request to be taped by your counselor without any ill effects to your counseling relationship. If you agree to be taped, you must sign a consent form.

Your Responsibilities

It is important that you take an active role in your health care by keeping follow up appointments, taking medication as directed, completing “homework” assignments, and discussing difficult issues. You are more likely to reap the benefits of our services when you invest time and effort into the process.

Please notify us at least 24 hours in advance to cancel an appointment. This way the time can be made available to other students.

E-mail is never fully confidential or secure. Providers may not check their e-mail on a regular basis and may miss your message.

If you have any questions about the information in this document, please feel free to discuss them with your provider before signing it. This page will be kept on file in the Total Health Center.


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