I understand that I may revoke this consent at any time, and that upon fulfillment of the above-stated purpose or lapse of 12 months from the date of signature, whichever comes first, this consent will automatically expire without my express revocation, but that revocation may not be applied retroactively once the information has been released in good faith. I understand Blue Sky MD Health and its staff cannot be responsible for confidentiality of information disclosed after said information has been released pursuant to this authorization, and I hereby release them from any liability arising from such disclosure and from all legal responsibility or liability that may arise from this authorization.