Authorization for Use or Disclosure of Health Information
Butte Superior Court · Criminal Forms
Verified current as of September 16, 2026
Form used by a client or patient to authorize sharing of their health or behavioral health records between named agencies, such as Butte County Behavioral Health, courts, or attorneys, specifying what information may be disclosed and for how long.
This form must be printed and filled by hand, or opened in Adobe Acrobat.