If you would like a copy of your record, please complete this form and submit it to Envision Counseling Clinic. The most confidential way to do so is by mailing it to us at:

Envision Counseling Clinic
Attn: Client Record Request
734 Wilcox St., Suite 202
Castle Rock, CO 80104

You may also email this form to us, though we advise you to encrypt the email. Our process is meant to be as efficient and as confidential as possible. Envision staff may contact you to discuss the scope, format, and other aspects of your request to facilitate confidentiality and efficiency.

Please be aware that Envision Counseling Clinic may not be able to provide records if (a) Envision has destroyed the records (according to the legal standards), (b) the records are being used in a civil, criminal or administrative action or proceeding, or (c) if the records could be reasonably likely to endanger someone. If ECC staff considers the request one of these exceptions, they will contact you in writing about the reason for making an exception.

If you would like the full record for counseling that occurred with more than one person (e.g. couples or family therapy), all adult individuals will need to give signed consent to release the record. A summary can be given to an individual regarding their participation in multiple-person therapy. The summary will not include the names of the other individuals involved.

Access Request Form

Click here for a copy of Envision Counseling Clinic’s Notice of Privacy Practices.