Tuesday, June 28, 2011

Involvement with U.S. Secret Service -- Evidence of Motive

In October 1994 I sent a letter to the Washington Field Office of the FBI that contained references to protectees of the U.S. Secret Service (USSS).  The FBI referred the matter to the USSS.  I was summoned to the Washington Field Office of the USSS by Special Agent Philip Leadroot (retired) for an interview in mid-December 1994.  Agent Leadroot had me sign a consent to release information form to be submitted to the George Washington University Medical Center Department of Psychiatry where I was an out-patient in treatment with Dimitrios Georgopoulos, M.D.  GW had me fill out the following form.  My statements are highlighted in yellow.  My statements make it clear that my intention in getting involved with the U.S. Secret Service was to prompt an investigation of the circumstances of my job termination, since all my previous letters to the Justice Department and the FBI were ineffective in prompting an investigation.  

My former employer had filed false sworn statements with the D.C. Government alleging that it had determined that I was potentially violent.  I had used the employer's false sworn declarations to obtain disability benefits from the U.S. Social Security Administration.  It was my good faith belief that violations of federal law had occurred and that the U.S. Department of Justice wrongly refused to investigate these violations.

The George Washington University
Washington, DC
Medical Center

Department of Psychiatry and Behavioral Sciences
Consent For Release of Information

I, Gary Freedman, of 3801 Connecticut Ave NW #136 Washington, DC hereby authorize Georgopoulos/Sotsky both M.D. to send Medical Records* to Philip C. Leadroot of U.S. Secret Service for the purpose of Psychological Evaluation in connection with determination by Govt of District of Columbia that I am potentially violent.

I understand that I may inspect this material and that I may request a copy for which there will be no charge.  This consent is subject to revocation by me in writing at any time.

I expressly understand and agree that no liability of any nature shall attach to the attending physician, clinician or employee in acting upon this authorization and request.

I further understand that this information cannot be redisclosed without my authorization, and that the law requires this notice:

The unauthorized disclosure of mental health information violates the provisions of the District of Columbia Mental Health Information Act of 1978.  Disclosures may only be made pursuant to a valid authorization by the client or as provided in Titles III or IV of the Act.  The Act provides for civil damages and criminal penalties for violations.

*Medical records includes any written charts, notes, correspondence, psychological or other test results or reports, test raw data or any other records of any kind in GW's possession

/s/ Gary Freedman

2/8/95

/s/ [illegible witness]

Copies of this consent form must be:

1) provided to the patient
2) included in the patient record
3) accompany disclosures

Division of Ambulatory Care
The H.B. Burns Memorial Building
2150 Pennsylvania Avenue, N.W.
Washington, DC  20037
Telephone (202) 994-4078
Fax (202) 994-6377

2 comments:

My Daily Struggles said...

Letter to Stuart Sotsky, M.D.:








http://dailstrug.blogspot.com/2010/06/george-washington-university-medical.html

My Daily Struggles said...

Per GW protocol (and consistent with DC law), patient records are destroyed after ten years.