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  • North Texas Family Services 

    Lauren Gordon, LCSW

    8301 Lakeview Parkway Suite 111-131

    Rowlett, TX 75088

    214.675.3978

    Directions: Please include yourself and any minor children you have legal responsibility for (conservatorship, guardianship, "custody," etc Please use additional copies if needed. Client(s):

  • The signature below hereby authorizes and requests the release of any and all records pertaining to the following:

  • These items are to be provided to Lauren Gordon, LCSW or any other entity with North Texas Family Services for the purpose of a court ordered evaluation. This consent is valid for one year from the date of signing. The client grants authorization for the release of records and will be responsible for the any fees incurred from the request.

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