Consent to Release of Information

Consent to Release of Information

This form is a consent to release information between two support professionals on the behalf(s) of mutual client(s). Client will receive a copy of this agreement upon submission. If you have any questions prior to submitting please contact Lyschel Burket at

  • DD dash MM dash YYYY
  • Coach/Therapist Information

  • Information will be released to: Hope Redefined 9813 Crestline Drive Knoxville, TN 37922 865-214-7778 Relationship to Client is: Coach, Group Facilitator, and/or Retreat Facilitator
  • Please check all areas that your info can be released in case there are different support persons responsible for one of your services.
  • This authorization lasts for one year after the date of submission unless otherwise noted by the client in this form. This authorization may be canceled in writing at any time. An email of this authorization will be treated in the same way as an original. By checking the box below and inputting your name this holds the same authorization as your signature. Your agreement indicates that you have read and understand this form, and authorize release of your information as described above.
  • MM slash DD slash YYYY

Discover Empowerment for the Betrayal Journey

Healthy boundaries are an essential part of the healing process.  Our Boundaries course is uniquely designed to give you real-time answers to your questions as you work through setting and sticking to your boundaries in daily life.

Are you struggling with feelings of betrayal and hopelessness?

Hope Redefined offers a 10-week Finding Hope Online Support and Study Group that offers participants an opportunity to overcome the devastation of betrayal. Participants will work through Hope Redefined’s Finding Hope workbook, which will help you better understand your pain and lead you to a place of healing.

Reflection, clarity, and courage

A Values workshop

Discover your inner strength and reclaim your values by reflecting and clarifying what is important to you, then step out with the courage to live by them daily. 

Need community support now?

As a woman experiencing sexual betrayal, the journey can feel lonely and isolating.  The confusion and shame can be paralyzing.  Take your first step toward healing today by joining the Hope Online Community. For a minimal monthly cost,  you get access to extensive resources and instant community support with women who are walking the same road.

Post Disclosure Support

Are you taking steps with your partner toward Full Therapeutic Disclosure?  Are you still reeling from the Rite of Truth? Do you lack direction now that you’ve walked through the disclosure process? 

We’ve been there, too! Find direction and community by joining our Post Disclosure support group.

Our Webinars are Available on Demand

For a minimal cost, you can gain immediate access to any of our webinars. Each one is designed to give you more information about a specific topic related to sexual betrayal.

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