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Waiver of Clinical Responsibility

I have read over practices and terms and assume responsibility for maintaining the privacy of clients under my care including the confidentiality of information shared with me. I also promise to uphold the privacy and sanctity regarding all other clients consulted on. Should information be disclosed during the course of a consultation making an individual's information identifiable to me, I will disclose any conflict of information that may impede my capacity to ethically serve a consulting role on that case.