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Mental Health Release of Information Form PDF

A Mental Health Release of Information Form is a document a mental health professional provides to their clients to properly acquire the consent required to use or disclose health information for treatment, payment, operations, and acknowledgement of receipt of HIPAA notice of privacy practices. Whether you’re just opening a new mental health private practice or you’ve been in business for years, having a Mental Health Release of Information Form is a major piece of the health of your private practice. You can purchase 1 copy and use our template digitally for every patient.

This Mental Health Release of Information Form PDF Template, part of our counseling intake form, can be downloaded and used with all your clients, giving them the ability to fill it out on a digital device or print it out. You can also upload to reputable docusharing websites and get signatures over a HIPAA safe system.

Get a Closer Look at What's Included

Click on an image below to get a closer look at what's included in this template.

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Benefits of Our Templates:

  1. Fillable PDF forms: Quickly fill out our template on a digital device like a computer or print out
  2. Not all text is editable, however, If you need to edit a question/words, we can provide you with a free site to make changes
  3. Each template purchase can be used for an unlimited number of clients
  4. Professionally designed to make your practice look its best
  5. Unlimited downloads
  6. Organize all your client documents in an easy to find folder on your computer or in the cloud
  7. Can be legibly read by both you and your clients
  8. Can be printed in high quality
  9. Standard U.S. letter size - 8.5" x 11"
  10. Search for specific parts your plan quickly by using "CTRL + f" function on your keyboard
  11. Can be uploaded to HIPAA compliant docusharing websites to gather appropriate signatures if needed remotely

This Product Includes:

  1. License for 1 mental health practitioner
  2. Fillable PDF template(s) that can be used on a digital device or printed out and filled in by hand
  3. Ability to be filled in or edit most text (we provide a free online tool to make edits if needed)

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