Please complete the Authorization form prior to your first visit.
In order to establish a therapeutic alliance, it is essential that the Therapeutic Relationship is understood to be sacrosanct. What is revealed in therapy will NEVER be disclosed without written consent. The relationship is based upon the Biomedical Ethics of respect for Autonomy, Beneficence, Non-Maleficence, and Justice.
You will be instructed to complete the Release forms as needed.
All forms will automatically be sent to your therapist and a copy sent to your email.
You do not need to "print" them.
Please Read the following Privacy Notice
(You are welcome to save a copy for your records)
If you would like to request your records from anyone. You my complete the Request for Information below to "Authorize" the release of your information to CCandA, LLC.