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Designate an emergency contact for mental health situations. Complete this form to ensure your safety and communication during a mental health crisis.

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What is mental health contact authorization?

Mental health contact authorization is a legal document that allows designated individuals or entities to access and share a person's mental health information.

Who is required to file mental health contact authorization?

Individuals seeking to allow others to access their mental health information or those managing individuals' mental health on their behalf are required to file mental health contact authorization.

How to fill out mental health contact authorization?

To fill out mental health contact authorization, one must provide their personal details, specify the parties authorized to access the information, outline the scope of the authorization, and sign the document.

What is the purpose of mental health contact authorization?

The purpose of mental health contact authorization is to ensure that individuals' mental health information is shared legally and confidentiality is maintained while allowing necessary healthcare providers access.

What information must be reported on mental health contact authorization?

Information that must be reported includes the authorized individual's details, the nature of the mental health information, the purpose of the authorization, and the timeframe during which the authorization is valid.

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