The undersigned patient or responsible party (parent, legal guardian, or conservator) consents to, and authorizes, services by Columbia Psychiatry. These services may include medication management, laboratory tests, diagnostic procedures, and other appropriate therapies. He/She/They understands that he/she/they have the right to be informed of and participate in the selection of treatment modalities; if requested, is entitled to a copy of this Consent; and has the right to withdraw this consent at any time. He/she/they understand that if signed consent is not given, Columbia Psychiatry cannot provide services to the patient.