Video/Audio Recording Release Video/Audio Recording Release 2020-05-19 Video/Audio Recording Release Videotaping and supervisory observations of sessions have been proven across many therapeutic settings to be an effective method to provide specific and efficient training and case support improving the outcomes for the families served. As a result, many of our programs require videotaping to aid in service delivery. We have adopted this “best practice” across the majority of our programs. Client name* First Last Client date of birth* MM slash DD slash YYYY All individuals being recorded must consent. Please check below:* I give permission to Child and Family Agency of Southeastern Connecticut, Inc. to video/audio record our meetings. I do NOT give permission to Child and Family Agency of Southeastern Connecticut, Inc. to video/audio record our meetings. I give permission for CFA staff and Evidence-based Model Consultants to observe my in-office live sessions. I do NOT give permission for CFA staff and Evidence-based Model Consultants to observe my in-office live sessions. By signing below: I understand that these recordings will be used for professional purposes only and will not be used outside the Agency. I further understand that these recordings will be destroyed within one year of the date of my signature unless I give permission in writing for them to be kept longer. I understand that I can revoke permission to record or observe sessions at any time. Client signature* Caregiver signature Caregiver relationship to client Date* MM slash DD slash YYYY
