The law protects the privacy of all communications between a patient and a psychologist. In most situations, no information about you will be
disclosed to anyone without your expressed authorization, except under the special conditions identified later in this section. A valid authorization
to share information about you related to your psychological services will include:
* the name of the person(s) or organization who will receive the information
*the specific information to be released
*the purpose of the disclosure
*the time frame the authorization will be valid
*a statement that I have no control over the use of disclosed information once it leaves my office
*the signature of the patient or legal representative and the date of signature