Client Forms
Release of Information
This form authorizes Hope Springs Behavioral Consultants to share your records with a designated provider or clinic.
Once we have a Release of Information (ROI) form on file, we are able to send information to the person or provider listed on the form. Please complete a separate form for each clinic or provider you wish to authorize.
Before you begin
- 1Have the name and contact information of the provider or clinic you are authorizing ready.
- 2Complete a separate form for each provider you wish to authorize.
- 3Submissions are reviewed by our administrative team. You will be contacted if any information is missing.
Release of Information
Other release forms
Need help?
If you have questions about this form or need assistance, our team is happy to help.