I hereby give my consent to participate in outpatient substance abuse treatment, including individual and/or group counseling, education, and related services as recommended by my treatment provider. I understand that participation is voluntary and that I may withdraw at any time.
I understand that information shared during treatment is confidential and will not be released without my written permission, except as required by law in cases of danger to self or others, or as otherwise legally required.
I understand that outpatient treatment may involve discussing difficult topics, which can sometimes cause emotional distress. Potential benefits include gaining support, education, and skills for recovery.