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Regent Mental Health Group Authorization to Release Information Client Name:___I authorize:Regent Mental Health Group 700 Radovan Dr, Ste 103 Madison, WI 53711To: Release and Obtainable of Birth:
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Go to the website www.regentmentalhealth.com/docs/release-of-regent-mental-health.
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Fill out the necessary information such as your name, contact information, and reason for requesting the release.
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Sign and date the form.
04
Submit the form to Regent Mental Health either in person or through email or fax.

Who needs wwwregentmentalhealthcomdocsrelease ofregent mental health?

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Individuals who are seeking to have their mental health records released to another healthcare provider.
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Patients who are transferring care to a new mental health provider and need to provide them with their past treatment information.
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The release of Regent Mental Health is a document that allows the sharing of personal information within the organization and with authorized individuals or entities.
All employees and staff members of Regent Mental Health are required to fill out and file the release form.
The form can be completed by providing personal information, signing and dating it, and submitting it to the designated department.
The purpose of the release form is to ensure confidentiality and proper handling of personal information within the organization.
The form typically requires personal details such as name, contact information, and signature.
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