I request that the Baltimore Therapy Center use the following electronic communication methods to communicate with me: *
Regarding the use of electronic communication methods: • I understand that e-mails sent to me are encrypted, but e-mails I send are not. • I understand that text (SMS) messages sent in either direction are not encrypted. • I understand the risks of using unencrypted methods as described in the Consent to Treatment. • I understand that I am not required to sign this agreement in order to receive treatment and that I have the right to terminate this authorization at any time.