Dbhdd authorization 2026

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The document is an authorization form from the Georgia Department of Behavioral Health & Developmental Disabilities, allowing individuals to consent to the release of their personal health information to specified parties. It includes provisions for disclosing sensitive information related to alcohol or drug abuse and HIV/AIDS, outlines the rights of the individual regarding their information, and specifies that treatment will not be conditioned on providing this authorization. The form also allows for revocation of consent.

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Click ‘Get Form’ to open the dbhdd authorization in the editor.
Begin by entering the Name of Individual/Consumer/Patient/Applicant and their Social Security Number and/or Date of Birth in the designated fields.
In the 'AUTHORIZATION FOR RELEASE OF INFORMATION' section, specify the name of the health care provider holding the information and their address. Ensure you include their phone or fax number for contact purposes.
Next, identify the person or agency to whom the information should be given, along with their address and contact details.
Indicate which specific information you authorize to be disclosed. If applicable, initial next to any sensitive information such as alcohol or drug abuse records or HIV-related information.
Complete the purpose of disclosure section by providing a brief explanation of why this information is being shared.
Finally, sign and date the form at the bottom. If necessary, have a witness sign as well, indicating their title or relationship to you.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Who is the commissioner of the public safety department in Georgia?

Colonel William W. Hitchens, III serves as the Commissioner of the Department of Public Safety.

How much does the Georgia Department of Behavioral Health and Developmental Disabilities pay?

Average Georgia Department of Behavioral Health and Developmental Disabilities hourly pay ranges from approximately $10.00 per hour for Shift Leader to $59.79 per hour for Psychologist.

What is the phone number for the Dbhdd in Georgia?

24-Hour Contact (Switchboard): 706-790-2011.

Who is the commissioner of the DDS in Georgia?

Moore Spencer R. Moore | Georgia Department of Driver Services.

Who is the commissioner of the Dbhdd in Georgia?

Kevin Tanner serves as the Commissioner of the Georgia Department of Behavioral Health and Developmental Disabilities.

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What is the Georgia Department of Behavioral Health and Developmental Disabilities?

The Georgia Department of Behavioral Health and Developmental Disabilities provides treatment and support services to people with behavioral health challenges and addictive diseases. They also assist individuals who live with developmental disabilities.

Who is the commissioner of the DHS in Georgia?

Candice L. Broce | Georgia Department of Human Services.

Who is the Commissioner of the Georgia Behavioral Health?

Kevin Tanner. Kevin Tanner serves as the Commissioner of the Georgia Department of Behavioral Health and Developmental Disabilities. Commissioner Tanner brings over three decades of public service experience, with a deep understanding of Georgias complex behavioral health continuum.