Release of Information

Authorization to Release and/or Exchange Client Health Information. This form is compliant with 42 CFR Part 2 (Confidentiality of Substance Use Disorder Patient Records) and HIPAA. Your identity will be verified by SMS before signing.

Need to revoke a prior authorization? Contact us at medrecords@serenitychristiancounseling.com or call (567) 429-1000.
  1. 1Verify phone
  2. ›
  3. 2Enter code
  4. ›
  5. 3Sign & submit

For your protection, we use SMS verification before processing a Release of Information. Please enter the mobile number where you can receive a text.