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How do I give my health care provider permission to share information about behavioral and mental health services, referrals and/or treatment for substance use disorders, or communicable diseases?

The State of Michigan Department of Community Health has developed a standard form for giving permission to share these types of health information. However, you should use a different, separate form if you have received services for domestic violence, sexual assault, or stalking. The person or agency that provided these services can give you the separate form.

Learn more about the Michigan Behavioral Health Standard Consent Form at