Sharing Information about CAPS Services

To protect your privacy and confidentiality, in most situations CAPS is required by law to obtain your written permission to use, disclose or release your protected health information and/or treatment records.

We would be happy to send your CAPS records to a third party with your written consent. Many other agencies, including Purdue University Health Center, use forms that do not meet our requirements. Using the Purdue CAPS Authorization for Use, Disclosure and/or Release of Protected Health Information will make it possible for us to release your records most quickly.

In most situations, CAPS can provide treatment summaries to address requests, when we have a completed release of information (see above). CAPS providers are able to complete third party forms when the requested information falls within CAPS scope of services.

The care manager may try to reach you if there are any questions, so please tell us your preferred contact method. You are welcome to call our office if you have any questions: 765-494-6995. We will not send confidential information over email and we request that you do not use email to send us a completed form.

For more information about CAPS Privacy Practices see