Behavioral Health
Behavioral Health
Authorization to Release Health Information
The following forms authorize us to get and give information about your health to those who you choose.
BHBillingandRecords@clackamas.us | |
Fax | 503-742-5312 |
11211 SE 82nd Ave., Suite O Happy Valley, OR 97086 |
Authorization Forms
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Records Request Forms
You have the right to request access to your health record.
- We cannot give you access to a clinician's private psychotherapy notes.
- We cannot give you access to information that we are no longer required to retain.
- If we deny your request, you have the right to request that we review that decision.
- You may be charged a fee for copies of your record.
BHBillingandRecords@clackamas.us | |
Fax | 503-742-5312 |
11211 SE 82nd Ave., Suite O Happy Valley, OR 97086 |
Download the form
New Format?
On