Net Neutrality

Affordable
Care Act

Deer Valley Counseling

Compassionate, Caring Counseling

Offices in Phoenix and Tempe

We answer the phones 7 days a week!

602.750.8051

Release of Information

Letters and Paperwork

Before requesting a letter, please download and read our Letters Policy. In addition, for both letters and other forms of paperwork, please see our Paperwork Policy.

From Deer Valley Counseling

If you would like for Deer Valley Counseling to release confidential information about you or your child to someone else, you must authorize us to do so in writing using this form—Authorization for Release of Confidential Information. Download the form, print it out, fill it out, and then fax it to Deer Valley Counseling. You will have to call 602.750.8051 for the fax number since we do not put that number on the internet. More information about the Deer Valley Counseling privacy policy can be found at Privacy.

To Deer Valley Counseling

If you would like another agency to release information to Deer Valley Counseling, you must authorize that agency to do so in writing using this form—Authorization for Release of Confidential Information To Deer Valley Counseling. Download the form, print it out, fill it out, and then fax it to Deer Valley Counseling. You will have to call 602.750.8051 for the fax number since we do not put that number on the internet.

Request for Copies

If you would like for Deer Valley Counseling to send you a copy of your file, you must request us to do so in writing using this form— Authorization for Release of Confidential Information. Download the form, print it out, fill it out, and then fax it to Deer Valley Counseling. You will have to call 602.750.8051 for the fax number since we do not put that number on the internet. Please note that if more than one person was present at a session, then we will have to receive an Authorization for Release of Confidential Information from each of the other persons present at the session before we can release the information for that session.

When Someone Besides the Client Is Paying

If you are guaranteeing someone else's sessions at Deer Valley Counseling, you will need to to read our payment policy (included in our notices packet) and then sign and return an Authorization to Charge Card. In addition, the client will need to sign an Authorization for Release of Payment Information.