According to HIPAA expert Nancy Wheeler J.D., of the American Counseling Association, when sending PHI (Personal Health Information) by email – and this is likely to include any email that identifies the recipient as a client / patient of a counseling practice, a counselor may use email only if a client has been advices of the risks and unsecured nature of email communication and still requests the use of email communication.

Note: the above description for email communication applies to normal “unencrypted” email communication. Encrypted email communications may not necessitate any of the above disclosures or agreement from clients, if the encryption meets standards acceptable my HIPAA, including 128 bit encryption.