I hereby authorize permission for my child to receive counseling from Mr. John L. Wood, LMFT, counselor for Holy Cross High School. The counseling is a confidential process except where disclosure is legally required. These situations include:
· When the therapist becomes aware of imminent danger of harm to a person,
· In compliance with a legal court order,
· When the client requests and signs a release of information to be shared.
By signing this form I also agree to participate in any needed meetings that may be necessary to assist in the well being, care and success of my child.
This permission must be completed, signed and returned to the school before any active therapy can begin. Upon receiving and signing this form, please feel free to contact the counselor to provide any background information that may be helpful and discuss any concerns you may have.