Guardian Release

I,

guardian of

, authorize the Volunteer Correspondent Program to appoint a Volunteer Correspondent for

.
I further authorize the Volunteer Correspondent Program to release information about

to the appointed Correspondent.

I understand that an appointed Volunteer Correspondent may have access to all living, and program areas and to all records related to

other than personnel records. I also understand that an appointed Correspondent will have some rights similar to those that I have as guardian, including participation in person-centered planning meetings and reviews, having a say about the plan and about where

’s behalf with my permission.

I consent to having an appointed Volunteer Correspondent. However, I understand that appointment of a Volunteer Correspondent in no way diminishes my legal rights and responsibilities as a guardian.I only approve the appointment of

other than personnel records. I also understand that an appointed Correspondent will have some rights similar to those that I have as guardian, including participation in person-centered planning meetings and reviews, having a say about the plan and about where

as Volunteer Correspondent for

. I understand that if I leave this sentence blank, the Volunteer Correspondent Program will attempt to recruit a person it considers appropriate to be Volunteer Correspondent for

.

I understand that I may withdraw this authorization at any time by notifying the Volunteer Correspondent Program in writing.