Release of Information Family and Friends:
If you would like a family or friend involved in your mental health care, please fill out this form: Family & Friends Release of Information
You will need one form per person involved in your care. This form is optional.
Release of Information for Agencies & Providers:
In order to best help provide services please fill out a Release of Information for the following:
- Previous Mental Health Providers/Agencies
- Pharmacy you are currently utilizing
- Primary Health Care Clinic
- Other agencies that you feel are applicable
*Intake may request additional Release of Information Forms filled out, per provider requests*
If you fill out your paperwork and do not hear back from someone in our intake department within 48 hours (this does not include weekends or holidays), please call 218-326-1274.