The Snowflake Clinic

Consent To Exchange Information With A Third Party

I give my consent to The Snowflake Clinic to obtain or share information with those individuals and organisations nominated below. I understand that the information shared will be limited to that which is relevant to my (or my child's) treatment and/or management of relevant psychological and emotional issues.

I agree and understand that the period of this consent is continuous and ongoing unless I expressly revoke my consent in writing to The Snowflake Clinic.

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