I want to thank all of my former patients for allowing me to be their counselor-therapist. I have retired from counseling and look forward to my new adventures. Please contact your insurance company to get help in locating a new therapist. If you need access to your records, please note that records will only be kept for 5 years after the last contact date. After that date the records will be pulled and securely destroyed.

Patient Files

To transfer your files to your new therapist, you will need to do the following

  1. fill out an Authorization to Release Protected Health Information Form
  2. Return the signed form to Dr. Dane.
  3. Faxing the records to the new therapist, will incur no charge. If you require hard (paper) copies then a fee for document generation and mailing, if applicable, will be required.

How to get a copy of your patient file:

  • Authorization for Use or Disclosure of Protected Health Information: This form must be completed before Dr. Dane or the PLLC may release any of your information. This form is required before a third party (Attorney, Family Member, or a new therapist) can receive your protected health information.
  • Click Here for instructions on how to fill out the Authorization to Release Patient Information.

How to fill out Authorization Form ยป

Fees for copy of Records

  • Please contact for a quote, include your full name at time of therapy