PDF
Word
Form DBH960E Attachment 4 Authority for Release of Information - Virginia
What Is Form DBH960E Attachment 4?
This is a legal form that was released by the Virginia Department of Behavioral Health & Developmental Services - a government authority operating within Virginia. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is DBH960E Attachment 4?
A: DBH960E Attachment 4 is a form titled 'Authority for Release of Information - Virginia'.
Q: What is the purpose of DBH960E Attachment 4?
A: The purpose of DBH960E Attachment 4 is to obtain authorization from an individual to release their information in Virginia.
Q: What information is released with DBH960E Attachment 4?
A: DBH960E Attachment 4 authorizes the release of personal and confidential information about an individual, including their medical and treatment records.
Q: Who needs to complete DBH960E Attachment 4?
A: Any individual who wants to allow the release of their information in Virginia will need to complete DBH960E Attachment 4.
Form Details:
- Released on January 1, 2023;
- The latest edition provided by the Virginia Department of Behavioral Health & Developmental Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form DBH960E Attachment 4 by clicking the link below or browse more documents and templates provided by the Virginia Department of Behavioral Health & Developmental Services.
