Information to be release: (including but not limited to)
Assessments: Initial Assessment, Diagnosis, Substance Abuse/Alcohol information, Behavioral, Medications, Therapy/Counseling Notes, Blood Work Results/Orders, Progress Notes, Treatment Concerns, Bariatric Concerns, Discuss finances with office staff.
Timing: This release will be valid until written notice to revoke this consent is provided to ACPC PLLC by patient/guardian and signed by both parties. Persons or agencies receiving information may not further release it without the informed written consent of the client/guardian.