I/We also, hereby authorize any person, corporation, society, organization, government agency, institution, or other entity to release to the New Hope Resource any information regarding my/our case records and/or circumstances.This Release of Information Authorization will remain in effect to the New Hope Resource Center one year after date indicated below.

I/We also, hereby authorize any person, corporation, society, organization, government agency, institution, or other entity to release to the New Hope Resource any information regarding my/our case records and/or circumstances.This Release of Information Authorization will remain in effect to the New Hope Resource Center one year after date indicated below.