Why do I need to fill out a Consent to Disclose form?
A Consent to Disclose form is standard documentation to uphold your confidentiality and privacy.
Your privacy matters to us. We will never share your information with anyone without your informed, written consent.
Verbal consent (by phone) or written communication (by email) cannot be used as consent to disclose. Instead, we require a form to be completed as documentation. The form is called a Consent to Disclose form.
To request the release of any information related to your therapy sessions, simply complete a Consent to Disclose form. The form lets you specify exactly what may be shared and with whom. You can also set an expiry date or limit the scope of disclosure at any time. Signing the form is completely voluntary — you may also choose not to sign it at all.
A Consent to Disclose Form is a written authorization required before any personal therapy information can be shared with a third party. Here are some examples of when a Consent to Disclose Form is required:
- To confirm or deny that you are receiving services at our clinic
- To release session information, such as chart notes and billing details, to anyone other than you
- To have another individual pay for your sessions, and/or receive the session receipts and invoices
- To share information with another healthcare provider involved in your care
- To have another individual manage your bookings, cancellations, and rescheduled sessions
- To verify session details with your insurance provider
If you need the form or have any questions, please reach out to our Care Team at hello@shiftcollab.com.
We are more than happy to support you!