I permit SCBTF partner Mental Health Providers to communicate and share basic personal data in compliance with ARPA data collection requirements. This data will include participant name, contact information, the number of sessions provided, administrative assistance with scheduling, referral agency and participant surveys. I understand that SCBTF, Sonoma County Black Forum, and its community partners will not access any HIPAA protected, personal and/or confidential information related to services provided by Partner Mental Health Providers and their clients, but are acting solely in an administrative and referral capacity.