Please Note: there is a risk that a limited release of information can potentially open up access by others to all of your confidential information held by Counseling Associates.
That I do not have to sign a release form. I do not have to allow Counseling Associates to share my information. Signing a release form is completely voluntary. That this release is limited to what I write above. If I would like Counseling Associates to release information about me in the future, I will need to sign another written, time-limited release. That releasing information about me could give another agency or person information about my location and would confirm that I have been receiving services from Counseling Associates. That Counseling Associates and I may not be able to control what happens to my information once it has been released to the above person or agency, and that the agency or person getting my information may be required by law or practice to share it with others.