Treatment Of Minor(s) & Others
Parents give my consent that Michael RoBards, LCSW and RoBards Counseling will be conducting psychotherapy with my child.
Parents also notified that all material discussed during the psychotherapy sessions is confidential and can be released only with the permission of the holder of the privilege. Parents have been informed of the limitation to confidentiality in the Office Policies form, which I have read and signed.
In the case of a minor, special sensitivity may be required in releasing information about certain topics such as drugs and sex. I will accept Mr. RoBards' judgment in regard to releasing or sharing information obtained during the course of psychotherapy with the minor that may endanger or jeopardize the client's wellbeing.
Parents give my consent that Michael RoBards, LCSW and RoBards Counseling will be conducting psychotherapy with my child.
Parents also notified that all material discussed during the psychotherapy sessions is confidential and can be released only with the permission of the holder of the privilege. Parents have been informed of the limitation to confidentiality in the Office Policies form, which I have read and signed.
In the case of a minor, special sensitivity may be required in releasing information about certain topics such as drugs and sex. I will accept Mr. RoBards' judgment in regard to releasing or sharing information obtained during the course of psychotherapy with the minor that may endanger or jeopardize the client's wellbeing.
