Privacy and Confidentiality

To Our Teen and Pre-Teen Patients:
It has been our great pleasure to take care of you as young children, and we look forward to spending many more years with you as your doctor or nurse practitioner.  Just as many of your relationships will change as you become older, our relationship with you will also start to change.

The first thing you will notice is that when you turn 12 years old we will ask your family to leave the room while you are examined.  This will give you some privacy for your exam.  Sometimes it is embarrassing to be examined with your family watching!

Speaking with you alone also gives us a chance to talk to you about topics that some teens have concerns about...things like smoking, drugs, alcohol and sex.  Sometimes you will laugh at us and sometimes you may have questions for us.

Anything we talk about during this private time is just between you and your doctor or nurse practitioner.  You are very welcome to share everything we talk about with your family, and in fact we encourage you to do so.  However, we will not discuss this information with anyone else unless you tell us it is OK.  There are a few exceptions to this rule.  If at anytime we think your life is in danger, if someone else is hurting you, or if we think that you are putting someone else's life in danger, then we will have to seek help.  This would involve us telling others.

Why do we do this?  We know a lot of teens do not speak to their doctor about many of these issues because they fear that the doctor will "tell on them".  We strongly believe that we can only help you to make good healthy decisions if you feel you can honestly talk to us.  We also believe that most families do provide the best support for their teens, so we will always recommend you talk with them as well.  But you will make this decision, not us.

As you get older, you will take more and more of the responsibility for your health care.  We look forward to helping you to become a happy, healthy and successful person during this time.

We provide confidential services to adolescents, but paying for those services may compromise confidentiality.  The biggest threat to confidentiality may be the Explanation of Benefits (EOB).  The EOB lists services provided and what insurers and policyholders pay to cover the cost of those services.  EOBs are generally sent to insurance policy holders (parents or guardians) to protect against fraud.   We try to work with insurance companies to set up policies to protect confidentiality, but billing processes sometimes makes that difficult.  If you want to be absolutely sure that no billing information will be sent to your parents, you will need to go to a clinic which can provide low cost or no cost health care.  Tapestry and Family Planning clinics allow adolescents to access confidential services and qualify for free or no cost care based on the adolescents own income.  Please ask us if you have more questions about confidentiality and billing concerns.

To the Parents of our Teen and Pre-Teen Patients:
Adolescence is an interesting time: a time of great physical change accompanied by equally great transformations in identity and maturity.  It is during these years that our children transition into the beautiful young adults we all want them to become.

Unfortunately, this time is not always risk free.  Many teens will struggle with issues around drugs, alcohol, sexuality and mental health concerns.  The medical providers at Holyoke Pediatrics will be there for our patients to address these issues in a nonjudgmental way.  We hope to give them all the information needed so that they can make informed decisions to protect their health.

We do this by introducing the idea of Privacy and Confidentiality starting at the 13 year physical.  At this appointment, we will meet with our patient and their family at the start of the visit.  We will then allow your teen to meet with the doctor or nurse practitioner alone for a few minutes and to be examined in private.  The family is invited back at the end of the visit.  As teens get older this private time will take up more of the visit, so that at 18 years of age the patient is able to do the visit alone if they wish.

During this private time, all teens are screened for high-risk behaviors.  Information shared at this time is confidential, unless the information shared indicates the teen is a risk to himself/herself or others.  This is necessary since many studies have shown that teens are unlikely to access the medical care they need without a guarantee of privacy.

We look forward to partnering with you to help your teen grow safely into a healthy adult.

Office Visits

After you are checked in by our front desk, you will be given pre-visit questionnaires to complete prior to your visit with your provider.

You will have your pre-visit work up completed by a nurse or medical assistant (vital signs, vision screen, hearing screen if needed, you may be asked to give a urine sample as well).  Your chart will be reviewed & updated.  If you need any updated school forms, MIAA forms or medication forms, please ask at the end of your pre-visit work-up. 

Your provider will meet with you & your parent/legal guardian to discuss any issues or concerns you may have.  At some point during the visit your provider may ask your parent/legal guardian to leave the room to give you one on one interaction with the provider.  When your exam is completed any immunizations will be discussed & given if necessary.  If you require blood work, it can be performed in our office on-site lab.

Please remember if you are under the age of 18, a parent/legal guardian must be present at your appointment.  We understand that this may not always be possible.  If your parent/legal guardian is unable to come with you, please have them complete the below form, "Consent for Non-Urgent Pediatric Care". 




Adolescent/Adult Release to Parent     
No esta disponible en español
Policy on Transition to Adult Health Care   Póliza sobre la transición a la edad adulta y al cuidado médico adulto
Consent for Non-Urgent Pediatric Care      
No esta disponible en español
Transition Letter to Adolescent Patients       a nuestros pacientes adolescentes
Transition Letter to Adolescent Parents       a los padres nuestros pacientes adolescentes
Transition Letter to Patients 17+   a nuestros pacientes que tienen 17+
Transition Letter to Parents 17+   a los padres de nuestros pacientes que tienen 17+
Immunization Schedule  
No esta disponible en español