This Consent to Release Information supports the referral process.
You must also submit the Local Care Team Referral Form.
Consent to Release Information
Montgomery County Collaboration Council
TO FAMILIES:
We can help you better if we are able to work with other agencies that may know your child and family. By signing this form, you are giving permission to the Collaboration Council to share information about your child. You will not be denied services for which you are eligible if you choose not to sign this form.