PRIVACY ACT STATEMENT
  1. The authority for soliciting the information comes from 10 USC 3012
  2. The purpose for soliciting the information is to provide the therapist/counselor data to assist in counseling you are seeking.
  3. The information will be maintained under strict professional guidelines at Rogue River Counseling. and until, by law, your records are released to be destroyed.
  4. Providing the information is voluntary. There will be no adverse effect on you for not furnishing the information other than that certain data might not otherwise be available to the counselor/therapist to enable him/her to provide you the most effective therapy.