Release of Information Example 

                         A few things to know about the intake process:

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It is important that you read the policy packet carefully with regard to prescribing medications and responsibilities for both the provider and yourself.  

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1) Please note that the Intake Packet MUST BE COMPLETED BEFORE AN INTAKE APPOINTMENT IS SCHEDULED 

 

2) ​The necessity to engage in individual therapy while also engage in medication management services will be discussed individually

 

3) The Release(s) of Information can be completed at your first appointment

Releases of Information are important in helping to coordinate your care; at a minimum they are required for PCP and individual therapist but may also be necessary for school(s), specialists and family members

      RELEASES OF INFORMATION IN THE INTAKE PACKET ARE FOR ONE PROVIDER PER PAGE.  PLEASE COMPLETE ADDITIONAL RELEASES AS APPROPRIATE. 

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4) Please note that we DO NOT complete forms or provide letters for emotional support animals at any time during treatment