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Authorization to Release Information I, hereby authorize New Day Psychotherapy Group and my evaluator/therapist to exchange clinical information and records obtained in the course of my diagnosis,
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Start by reading the authorization form thoroughly to understand the terms and conditions.
02
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What is by signing this authorization?
By signing this authorization, you are giving permission for a specific action to be taken.
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The purpose of signing this authorization is to give legal permission for a specific action to be taken.
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The authorization may require reporting of personal information, details of the action being authorized, and any relevant dates.
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