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Mental Health Release of Information Form

Collaborate with your colleagues at other practices while meeting your HIPAA obligations using our free mental health release of information form.

Ericka Pingol avatar

By Ericka Pingol on Aug 2, 2025.

Fact Checked by Nate Lacson.

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Mental Health Release of Information Form Template

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Commonly asked questions

Yes, a legal guardian or designated family member can sign the Mental Health Release of Information Form if the patient cannot do so. However, additional state law requirements may apply, so it's important to check the specific legal guidelines in your area.

Yes, you can specify an expiration date on the release of information form. This determines how long the authorization remains valid. After the expiration, the healthcare provider can no longer share your medical information without a new authorization.

The mental health release form allows you to specify which parts of your mental health records you wish to release, such as details related to your treatment plan, medical history, or any substance abuse or drug abuse treatment. This ensures that only the necessary medical information is shared.

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