Oca 960 2026

1. Click ‘Get Form’ to open the oca 960 in the editor.
2. Begin by entering the Patient Name, Date of Birth, and Social Security Number in the designated fields. Ensure accuracy as this information is crucial for identification.
3. Fill in the Patient Address to provide a complete contact detail. This helps in any necessary follow-up regarding the health information.
4. In Item 9(a), specify what health information you wish to release by checking the appropriate boxes. If applicable, initial next to Alcohol/Drug Treatment, Mental Health Information, or HIV-Related Information.
5. Complete Item 7 with the name and address of the health provider releasing your information. In Item 8, indicate who will receive this information.
6. Finally, sign and date the form at the bottom. If someone else is signing on behalf of the patient, ensure their authority is noted in Item 13.

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