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Browse Judicial Forms Forms by Category JV-226 Authorization to Release Health and Mental Health Information (Dependency)

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Details for JV-226 Authorization to Release Health and Mental Health Information (Dependency)

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Name:JV-226 Authorization to Release Health and Mental Health Information (Dependency)
Description:
Price $9.99
JV-226 Authorization to Release Health and Mental Health Information (Dependency)
This form authorizes the release of the child’s health and/or mental health records to the child welfare agency to ensure that the child receives appropriate and effective services. It also allows the agency to carry out its case management responsibilities; to monitor treatment, health-care operations, and billing and payment; and to inform the court of the child’s medical and/or mental health needs. This form complies with the Health Insurance Portability and Accountability Act (HIPAA), Confidentiality of Medical Information Act (CMIA), and Lanterman-Petris-Short (LPS) Act.
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Filesize: 270.14 kB
Filetype:pdf
Release date: 07/01/2013