Mental Health Crisis Response Records Request Form

Requesting mental health crisis response records shouldn't be complicated, especially when continuity of care is critical. This Mental Health Crisis Response Records Request Form helps healthcare providers, case managers, and patients streamline the process of gathering essential mental health documentation for coordinated treatment.

Whether you're a psychiatric facility, crisis intervention team, outpatient mental health clinic, or emergency department, this form template captures everything needed to request comprehensive mental health records—including previous hospitalizations, medication trials, treatment team contacts, and emergency response history.

Built with Paperform's flexible form builder, this template uses conditional logic to show relevant follow-up questions, ensuring you collect complete information without overwhelming requestors. The clean, professional design maintains patient dignity while meeting HIPAA authorization requirements (note: Paperform is not HIPAA compliant, so healthcare organizations must use additional safeguards for protected health information).

Once submitted, you can use Stepper (stepper.io) to automate your records request workflow—automatically routing requests to the correct departments, sending confirmation emails to patients, creating follow-up tasks for your medical records team, and tracking request status across multiple facilities. For cases requiring patient or guardian consent signatures, Papersign (papersign.com) can convert authorizations into legally binding eSignature documents that maintain audit trails.

This form is ideal for mental health professionals, hospital discharge planners, crisis stabilization units, community mental health centers, and care coordination teams who need accurate patient history to provide effective, trauma-informed treatment during critical moments.