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Behavioral Health Associates 6216 Airpark Drive Chattanooga, TN 37421 pH: 4238990024 Fax: 4238995688 Authorization to Release Healthcare Information Patients Name: Date of Birth: Legal Guardians Name
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Behavioral health associates 6216 is a form used by healthcare providers to report information related to behavioral health services provided to patients.
Healthcare providers who offer behavioral health services are required to file behavioral health associates 6216.
Behavioral health associates 6216 can be filled out by entering the required information about the behavioral health services provided to patients.
The purpose of behavioral health associates 6216 is to track and report behavioral health services provided by healthcare providers.
Information such as patient demographics, type of services provided, and dates of service must be reported on behavioral health associates 6216.
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