At times it is helpful for Giant Steps to gather information about our clients from other providers. Please provide the names and contact information for health care providers and educators who work with you / your child. You may refuse to sign this form. You may cancel it at any time by informing Giant Steps Therapeutic Equestrian Center in writing. If you cancel your permission to allow the release of information about you / your child, it will go into effect immediately (unless someone already released information). You have the right to receive a copy of this Authorization.
Expiration: This authorization is ongoing unless cancelled in writing by the client or their caregiver.
Restrictions: Providers who receive this information may not release it to someone else unless another authorization form is signed.
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