The Counseling Center

• Rights, Privacy, Responsibilities, and Consent for Treatment for a Minor
• Authorization for Release of Protected Health Information
• Authorization for Release of Information - Say Yes Program
• Consent for Assessment & Treatment
• Telecounseling Informed Consent

Note: Forms that cannot be submitted digitally must be faxed or mailed to the Counseling Center.

Fax: 716.878.3003

Mailing Address:

COUNSELING CENTER
Weigel 219
1300 Elmwood Ave.
Buffalo, NY 14222-1095