2. To choose whether to enter, continue, or terminate a counseling relationship. 3. To have a part in determining which counselor will provide counseling for you. 4. To bring to yo ur counselor any concerns or questions regarding your counselor or the counseling process. 5. To work jointly with your counselor in establishing counseling goals.
The Authorization for Release of Confidential Information for m must be completed and signed by: The person whose information will be released, or The parent or legal guardian of a minor whose information will be released except as listed The personal representative of the person whose information will b e released (e.g., power of attorney, conservator, legal guardian, executor Fill in the name and date of birth of the person whose information will be released.
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