Get Dhs Behavioral Health Agency Form 200 - Accreditation Release Form

Filling out the DHS Behavioral Health Agency Form 200 - Accreditation Release Form is a crucial step in facilitating the exchange of information relevant to behavioral health agency certification. This guide provides a clear and supportive overview of how to efficiently complete the form online.

Follow the steps to complete the form accurately

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by providing your name in the space marked 'I, __________________________,' to identify the individual consenting to the information exchange.
3. Next, indicate the name of your agency’s Chief Executive Officer (CEO) or equivalent in the provided field.
4. In the section titled 'Accrediting Agency,' write the name of the agency that will receive the information.
5. Review the statement: 'I consent to information regarding my agency’s national accreditation or state certifications being released by facsimile (FAX).' Indicate your preference by selecting 'Yes' or 'No.'
6. Be aware that the information you authorize for release may include sensitive information. Acknowledge this by reading the accompanying note.
7. Sign and date the form in the designated spaces for the CEO (or equivalent).
8. Ensure a witness also signs and dates the form in the provided spaces.
9. Once all fields are completed, you can save changes, download, print, or share the form as needed.

Start completing your DHS Behavioral Health Agency Form 200 online today!