Get the free I, , authorize Coastal Horizons Center Inc - coastalpreventionresources

COASTAL HORIZONS CENTER, INC. “Promoting choices for healthier lives and safer communities Authorization For Use And Disclosure Of Protected Health Information This form is to be completed by the

How to fill out i authorize coastal horizons

How to fill out i authorize coastal horizons:

1. Start by reading the form carefully and ensuring that you understand each section.
2. Provide your personal information, such as your full name, date of birth, and contact details, in the designated fields.
3. If applicable, provide information about the program or service you are authorizing Coastal Horizons to provide.
4. Sign and date the form, indicating your consent and authorization.
5. Make a copy of the completed form for your records before submitting it to Coastal Horizons.

Who needs i authorize coastal horizons:

1. People who are seeking services or participating in programs offered by Coastal Horizons may need to fill out the "I authorize Coastal Horizons" form. This form is typically used to obtain the necessary consent and authorization to provide services, access medical records, or share personal information.
2. Clients who are receiving counseling, therapy, or other mental health services may be required to complete this form.
3. Individuals who wish to participate in substance abuse treatment programs or receive support for addiction issues may also need to fill out this authorization form.

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