COLUMBUS BEHAVIORAL HEALTH 614.360.2600
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Forms

Release of Information


Click here to access the Authorization for Release of Information form (ROI)
 Release of Information is OPTIONAL, if you have someone you want us to share your information with (physician, family member, another provider, etc)



Columbus Behavioral Health
​Phone: 614-360-2600
​Fax: 844-320-2600


Phones answered 8 am-5 pm, Monday-Friday
Messages/faxes received outside of these hours will be returned the next business day.

Dublin Location:
6631 Commerce Parkway
Suite R
​Dublin, OH 43017

​
New Albany Location:
5071 Forest Drive
​Suite B

New Albany, OH 43054

​
Westerville  Location:
635 Park Meadow Road
Suite 101
Westerville, OH 43081
​
The information on this website is intended for instructional purposes only and is not intended as a replacement for therapy or treatment. If you are a danger to yourself or others, go to your local ER to be assessed immediately.

​Our Policies
Notice of Privacy Practices
  • Home
  • About
    • About Us
    • Our Providers
    • Services >
      • Therapy
      • Psychiatric Medications
      • Nutrition Services
      • Trainings
  • Appointments
    • New Patients
    • Current Patients
    • Patient Portal
    • Insurance
    • Password Reset
    • COVID-19 Response
    • Instructions for Virtual Sessions
    • Blueprint FAQ
  • Paperwork/Forms
    • New patient paperwork
    • Couples counseling paperwork
    • Telehealth Consent Form
    • Release of information ROI
    • In person consent form
    • Privacy Practices
    • Policies/Service Agreement
    • 2021 Info Update Form
  • Referrals
  • Resources
    • ADHD Testing
    • Addiction Services
    • Crisis/Inpatient
    • Self Help >
      • Adults >
        • Abuse/Violence
        • Academic Problems
        • Addictions
        • Adjustments
        • Anxiety
        • Athletes
        • Bipolar Disorder
        • Breakups
        • Career/Job
        • Depression
        • Family of Origin Issues
        • Food/Body Image
        • Gender issues
        • Grief & Loss
        • Postpartum Issues
        • Relationship Problems
        • Stalking
      • Children/Families >
        • ADHD/Concentration
        • Childhood Anxiety
        • Depression
        • Children & Divorce
        • Eating Disorders in Children
        • Kids & Friend Problems
        • Learning Problems
        • Teen Dating Violence
      • Couples >
        • Addiction
        • Connection Difficulties
        • Conflict
        • Infidelity Recovery
        • Infertility
    • Videos
    • Children & Teens
    • National Resources
    • Relationship Violence Resources
    • Support Groups
  • Contact
    • Contact Info
    • Feedback
    • Join Our Team!