1.1.      Consent to Procedures: To arrange for and consent for urinalysis.

1.2.     Access to Medical Records and Other Personal Information: The Principal hereby authorizes all physicians and psychiatrists who have treated the Principal, and all other providers of health care, including hospitals, to release to Bridging The Gap International all information in the Principal’s medical records which Bridging The Gap International may request. With respect to Bridging The Gap International only, the Principal hereby waives all privileges attached to the physician patient relationship and to any communication, verbal or written, arising out of such a relationship. Bridging The Gap International is authorized to request, receive and review any information, verbal or written, pertaining to the Principal’s physical or mental health, including medical and hospital records, and to execute any releases, waivers or other documents that may be required in order to obtain such information, and to disclose such information to such persons, organizations and health care providers as Bridging The Gap International may designate