CURRENTLY ACCEPTING NEW PATIENTS IN TEXAS, VIRGINIA, COLORADO AND MISSISSIPPI

School Release Form

I hereby authorize the release of records, documents, or other information concerning DOB

The named individual’s attorney and/or his/her representative.

This release covers all school records, including but not limited to, records pertaining to discipline, expulsions, suspensions, attendance, grades, transcripts, testing results and special education.

I understand that (enter name below) and his/her staff will regard as confidential and privileged any information thus released to them, and will use said information for the sole purpose of assisting me with the legal matters upon which I Have sought their advise and assistance.

A copy of this Authorization shall be as valid as the original. This authorization is effective immediately and expires one year from the date below.

Date

Signature

Print full name

First Last

Relationship to student

Phone number

Contact Us Free

512-843-5169

online support available

[email protected]

Office Address

6705 W. Hwy 290 Ste 607 Austin, TX 78735

At Prestigious Guidance Services, PLLC, we believe in a world where compassionate care meets the highest standards of psychiatric practice. Our team, led by seasoned professionals, is dedicated to offering evidence-based treatment in a supportive, nonjudgmental space. Guided by values of integrity, empathy, and respect, we’re not just your healthcare providers — we’re your partners in the journey toward mental wellness.

CURRENTLY ACCEPTING NEW PATIENTS IN TEXAS, VIRGINIA, COLORADO AND MISSISSIPPI

Contact Us Free

Online Support Available

School Release Form

Contact Us Free

online support available

Office Address

Quick Links

Our Services

Hours of Operation

Contact Us