Records Request
If you need to request clinical records for yourself or your child, please review the information below. We are committed to protecting the privacy and confidentiality of every child and family we serve.
How to Request Records
Complete the Online Form
Fill out our secure Records Request Form online. You will need the client's full name, date of birth, the specific records being requested, and the name and address of the person or organization the records should be sent to.
Sign Electronically
The form must be signed by the parent or legal guardian of the minor client. If the client is 18 or older, the client must sign the authorization themselves. The form includes an electronic signature field — no printing or mailing required.
We'll Take It from Here
Once we receive your completed authorization, our team will process your request. Records are typically processed within 30 days. We will contact you if we need any additional information.
Ready to Submit?
Complete and sign the form online — it only takes a few minutes.
Submit Records Request →Questions? Call 561-244-9499 or email info@centerforchildcounseling.org
What You Should Know
Center for Child Counseling is committed to protecting the privacy of every child and family we serve, in accordance with the Health Insurance Portability and Accountability Act (HIPAA), Florida state law, and our organizational policies.
Records will only be released to authorized individuals as specified on the signed authorization form. We may provide a clinical summary rather than full session notes when it is in the best interest of the child's care and safety.
There may be a reasonable fee associated with copying and processing records. You will be notified in advance of any applicable costs.
For questions about the records request process, please call us at 561-244-9499 or email info@centerforchildcounseling.org.
Privacy Notice
For more information about how we protect your personal health information, please review our Notice of Privacy Practices.
Need Help?
If you have questions about the records request process, our team is here to assist you. You can also visit our FAQ page for answers to common questions about our services.