Release of Information
PO Box 25314, Colorado Springs, CO 80936Email: firstname.lastname@example.orgPhone: 719-590-SOUL (7685)
I, (client’s printed name) give permission for Jayson Graves, Healing for the Soul and all its agents to communicate with the following person(s) regarding the confidential information of our coaching relationship:
I understand that the information shared and gained about me, my coaching and all other personal information will remain confidential within these relationships and is still governed by all applicable confidentiality laws of my state and the State of Colorado.
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Your legal name
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Document Name: Release of Information
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