The McBurney Center's Authorization for Release of Confidential Information Form is a Word document that can be filled out by the student and submitted to the McBurney Center to obtain copies of records for self, allow a the McBurney Center to request copies of records from a clinician, allow service providers to communicate with McBurney Center staff, and other legitimate records release uses.
McBurney Authorization for Release of Confidential Information Form
Download McBurney Authorization for Release of Confidential Information Form