ARCHDIOCESE OF
DIACONAL FORMATION
PROGRAM
RELEASE
I,
___________________________________, understand that in order to be admitted to
Candidacy in the Diaconal Formation Program (“Candidacy”), which could lead to
reception of Holy Orders (“Holy Orders”) in the Roman Catholic Church, I must be
interviewed by one or more clinical psychologists (the “psychologist(s)”) chosen
by the Archdiocese of Atlanta (“the Archdiocese”) for the purpose of evaluating
my fitness to enter Candidacy and to continue formation (the “evaluation”). I hereby grant permission to the
Archdiocese to schedule my interview with a psychologist, selected by the
Archdiocese, for the purpose of the evaluation.
I understand that
the results of this evaluation become the property of the Archdiocese and that
any reports (the “evaluation reports”) provided by the psychologist(s) will be
maintained by the Archdiocese as confidential, and will not be disclosed to
third parties, other than necessary Archdiocesan employees, including, but not
limited to, those involved in the decision to admit me to Candidacy (“necessary
Archdiocesan employees”), or as may be required by law. I also understand that I
am not entitled to review or obtain a copy of any such evaluation reports. Notwithstanding the foregoing, the
contents of any such reports may be reviewed with me by necessary Archdiocesan
employees, at the sole discretion of the Archdiocese.
Signed this date
____________________
Signature
_________________________
Witness
__________________________