Why caregiver access may be limited

Best first step: Check what type of access the caregiver has. Portal access, proxy access, support-person status, release of information, emergency contact status, and legal authority may all work differently.

• Caregiver access may be limited by patient choice, privacy rules, legal status, age, and the type of information requested.
• Being a caregiver, family member, emergency contact, or support person does not automatically allow full record access.
• Behavioral health notes, medication details, crisis referrals, safety plans, and sensitive records may have additional restrictions.
• Children and dependents may have different proxy rules than adult patients.
• Adult patients can usually decide who may receive information or help manage care.
• Caregivers can usually still share safety concerns, even if Silent Hill Health cannot share private information back.

Reason access may be limited	What it may affect
Patient choice	An adult patient may limit who can see records, receive calls, attend discussions, or help manage care.
Sensitive information	Behavioral health, medications, safety planning, crisis care, reproductive care, substance-use care, or other protected details.
Age or dependent status	Proxy access for children, adolescents, dependents, or adults under legal authority may change based on age and rules.
Legal documentation	Guardianship, custody, power of attorney, conservatorship, or representative authority may need verification.
Different access systems	Portal access, emergency contact status, release of information, billing roles, and visitor approval may not all update together.

• The caregiver can see appointments but not clinical notes.
• The caregiver can help schedule but cannot view medication details.
• The caregiver can message about logistics but cannot discuss treatment details.
• The caregiver can attend a visit only when the patient agrees.
• The caregiver can receive discharge logistics but not sensitive safety-plan details.
• The caregiver can share concerns but cannot receive confirmation or updates back.
• The caregiver can access one service but not another service under Silent Hill Health.

Important: A caregiver may be involved in support without being allowed to see all behavioral health notes, crisis records, medication details, safety-plan information, or provider comments.

• Therapy notes or provider notes may be limited.
• Crisis referrals and safety reviews may have restricted details.
• Medication reasons or side-effect discussions may be sensitive.
• Discharge safety plans may not be visible in full to proxy users.
• Some information may need direct patient approval before it can be shared.
• Some information may require formal records review instead of portal access.

• Parent or guardian access may require verification.
• Some adolescent records may have additional privacy limits.
• Proxy access may change automatically at certain ages or milestones.
• Custody, guardianship, or legal documentation may need review.
• Some sensitive information may remain limited even when proxy access exists.
• Adult dependents may need their own authorization unless legal authority applies.

• The patient may choose who can receive information.
• The patient may limit what information can be shared.
• The patient may authorize a support person for some care settings but not others.
• The patient may remove or update authorization later.
• Silent Hill Health may need identity verification before changing access.
• Legal documents may be required if someone is acting as a representative.

Portal issue	What it may mean
Caregiver can schedule but cannot see notes	Scheduling access may be allowed while clinical record access is limited.
Medication information is missing	Medication details may be restricted, delayed, or visible only to the patient.
Behavioral health notes are not visible	Sensitive notes may require patient approval, provider review, or formal records request.
Proxy access changed suddenly	Access may have changed because of age, patient update, legal review, or privacy setting changes.
Caregiver can see one patient but not another	Access is tied to each patient record and may not apply across family members or dependents.

• Share safety concerns with the care team.
• Help the patient prepare questions for a visit.
• Help with transportation, parking, check-in, or appointment reminders.
• Help pick up medications if allowed by the pharmacy and patient.
• Help track side effects or symptoms with the patient’s permission.
• Help the patient request updated access or add authorization.
• Help with discharge logistics, belongings, or follow-up planning when approved.

• Ask what type of access is currently active.
• Ask whether patient authorization is missing or expired.
• Ask whether portal access, release of information, or support-person status is separate.
• Ask whether legal documentation is needed.
• Ask whether sensitive information rules limit the record view.
• Ask whether the patient needs to approve additional access.
• Ask when changes will take effect after review.

Do not wait for a portal access update, proxy review, records request, or routine callback if the issue involves immediate safety, abuse, coercion, stalking, unauthorized access during an emergency, or someone using access to interfere with care.

• If you are at Brookhaven or Alchemilla, tell reception, registration, security, or the care team immediately.
• If someone may harm themselves or someone else, use crisis or emergency support.
• If there is a medical emergency, use emergency services or Alchemilla Emergency Services.
• If portal access is being misused, ask for immediate account or privacy review.
• If a caregiver is worried about a patient’s safety, they can share concerns even if access is limited.