I provide permission and consent for Positive Perspective Therapy, LLC to obtain and release information for the purposes of coordinating care with an outside person or company. *

I consent to the above terms.

I agree that information can be sensitive and clinical, however I know that my therapist will be sharing this information for my best interest and in efforts of providing the best clinical care. *

I consent to the above terms.

I consent to allowing my therapist to utilize the following forms of communication: email, phone call, text message and fax. *

I consent to the above terms.

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