The releasor authorizes his/her employer to release employment references including, but limited to, his/her employment history and wages and any information which may be requested relative to his/her employment, employment applications, and other related matters, and to furnish copies of any and all records which the employer may have regarding his/her employment.
Release Of Information For Mental Health In Collin
Category:
State:
Multi-State
County:
Collin
Control #:
US-00458
Format:
Word;
Rich Text
Instant download
Description
Form popularity
FAQ
By signing this form, you authorize the institution to which this form is submitted to release your information to the requester or their authorized representative. The consent must be signed and dated by the person giving the consent.
What is a mental health release of information form? A mental health release of information form outlines who has access to your client's medical records and under what circumstances they have access. This form is signed and acknowledged by your client.
A description of the information that will be used/disclosed. The purpose for which the information will be disclosed. The name of the person or entity to whom the information will be disclosed. An expiration date or expiration event when consent to use/disclose the information is withdrawn.
The Mental Health Intake & Evaluation Forms describe background information, basic medical history and current functioning (such as mood and thought processes) needed for the intake process.
Accessing Mental Health Records In most cases, patients can access their records by contacting their healthcare provider directly. However, patients may also need to submit a written request. The process for doing so will vary depending on the healthcare provider.
HIPAA permits health care providers to disclose to other health providers any protected health information (PHI) contained in the medical record about an individual for treatment, case management, and coordination of care and, with few exceptions, treats mental health information the same as other health information.
If you are not using a form, be sure to include the full name, address, phone number, and secure fax or secure email address where the provider can send you the records.
You may declare or change a program of study in the student tab of Cougar Connect or at the Admissions and Records Office (ARO).
Students are expected to maintain satisfactory academic progress while enrolled at Collin College. Satisfactory Academic Progress (SAP) is defined as maintaining a 2.0 cumulative GPA. A grade of 'D' or better received at Collin or any other college is a passing grade and may not be repeated for benefits.
Changes of address affecting residency classification should be reported promptly to the Admissions Office, along with documentation of current address. Name and CollegeWide ID number (CWID) changes require photocopies of the student's Social Security card or Texas Driver's License.
