I understand that the information indicated is protected and cannot be released without my written permission, unless otherwise permitted by law. My signature below indicates that I have read this release and have had the benefits, risks, and consequences of releasing or not releasing information explained to me. I understand that I have a right to review all materials prior to their release to or from ABHS and that the materials to be released will be reviewed with me upon my request. I understand that I do not need to sign this form to receive services and that I may review ABHS Notice of Privacy Practices before I sign this form.