To provide holistic care, it can be helpful to collaborate with other professionals involved in your or your child's treatment. We require your (or your child's Legal Guardian's) consent before sharing or requesting any information. This consent is voluntary, can be withdrawn at any time, and expires 12 months from the date it is given. By signing this form:
I give consent form my clinician to release information to the individuals or professionals involved in my care for the purpose of collaboration
I understaad that I may withdraw this consent at any time by notifying my clinician
I give consent for my clinician to obtain information from the individuals or professionals involved in my care for the purpose of collaboration
I understand that I may withdraw this consent at any time by notifying my clinician
