authorize all extended family members, friends and child care providers who are known to us or our child(ren) to exchange any and all information regarding the parents and/or our children with Mitchell Rosen, LMFT. We authorize the release of any information requested by Mitchell Rosen, LMFT. The purpose of this exchange of information is to assist in the completion of a Court ordered child custody or psychological evaluation. The foregoing authority shall continue in force until revoked by one or both parents/guardians in writing. A faxed or photocopy of this release shall be considered as an original.