Please email bloomrecovery@gmail.com if the Authorization for Disclosure of Confidential SUD Records included in this registration process does not accurately reflect the following:
-How much and what kind of information you want disclosed,
-The purpose for that disclosure
-The date, event or condition upon which the consent will expire,
-OR disclosure to any other person or agency beyond your sentencing court (such as an Attorney, PO, other referring agency or individual)
This Authorization for Disclosure form is specific to your sentencing court and disclosure of the information we are required (or may be requested) to provide.