Page 114 - Juvenile Practice is not Child's Play

Release of Records and Information

Counsel should obtain:

1. The client’s and parent’s or guardian’s signatures on releases giving counsel the right to inspect all school,

medical, psychological, and other agency records relating to the client (see below);

2. Where appropriate,

(a) Information relating to bail.
(b) A signed retainer and fee agreement.

RELEASE OF RECORDS AND INFORMATION FORM

I, [name of client], am currently being represented by [name of counsel and counsel’s organization or law firm].

I hereby authorize you to release to [name of counsel] and his or her law partners, investigators, social workers,
and other employees, any and all records including (but not limited to) educational evaluations and school records
(including my cumulative record folder and all its contents, all academic records, special education records, guidance
reports, anecdotal records, incident reports, records kept by the guidance counselor, and any other records maintained
by the school), as well as medical, social, psychiatric and psychological records, and any and all records and reports
prepared by social workers.

I understand that my right to confidentiality means that you cannot share this information without my consent.
I fully understand that I am requesting that you reveal confidential information to the named individual(s). I feel that
[name of counsel] will be able to use the material to help me, and I am authorizing the release of this information for
that reason.

__________________________
Signature of client

__________________________
Client’s date of birth

__________________________

Date of Signature