• Record Release Request Form

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  • Please note: This email is not encrypted. Records are sent in a pdf format to the email address entered.

  • I hereby authorize Norwood Behavioral Health to release any medical information as requested above. This may include information about drug or alcohol use, psychiatric, social work, or other protected information unless otherwise excluded, such as psychotherapy notes. I am aware that Norwood Behavioral Health cannot control how the recipient uses or shares the information, and that laws protecting its confidentiality at Norwood Behavioral Health may or may not protect this information once it has been disclosed to the recipient.

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