In clinical evaluations, patients voluntarily seek clinical attention. A doctor-patient relationship exists, and the patient is the holder of privilege. This means the discussions between doctor and patient and evaluation findings are confidential. Patients own their records, can access them, and the clinician may not disseminate the record unless the patient opts to divulge it. Other HIPAA-related rules apply.

Because these contextually-differing rights are not necessarily intuitive, and examining physicians and psychologists are naturally perceived as members of the “helping profession,” it is critical that examiners assuming a forensic role make clear to the examinee the absence of a doctor-patient relationship and limits of confidentiality at the start of the evaluation, clarify questions or concerns raised at that time, and include a full description of the examinee’s waiver in any report that is produced.