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How to use or fill out the Atlantic Health Release of Information Form
- Click ‘Get Form’ to open it in the editor.
- Begin by entering your personal information, including your name, date of birth, and phone number. This ensures that the records pertain specifically to you.
- Specify the treatment dates needed and check the appropriate boxes for the reports you wish to receive, such as medical tests or psychiatric treatment records.
- Fill in the recipient's details, including their name, phone number, and address. Indicate whether you want the records picked up or mailed.
- Review the authorization terms carefully. Ensure you understand that this consent is valid for six months unless revoked in writing.
- Sign and date the form at the bottom. If applicable, include a signature from a legal guardian or authorized representative.
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