Records Request
Which forms to use and how to use them:
For Professionals Whose Client Is Under Age 18:
  • Have the guardian complete an AK Crossings Release of Information- Guardian form, or have the client complete an AK Crossings Release of Information- Client form. If the client has a substance related disorder, client signature is required.
  • Fill out a Request for Documents- Outside Source form.

For Professionals Whose Client Is Age 18 or Older:
  • Have the client complete and sign an AK Crossings Release of Information- Client form.
  • Fill out a Request for Documents- Outside Source form.

For Parents/Guardians of a Client Under Age 18:
  • If the client has a substance related disorder, have the client fill out an AK Crossings Release of Information- Client form.
  • Fill out a Request for Documents- Guardian-Client form.

For Parents of a Client Age 18 or Older:
  • Have the client fill out an AK Crossings Release of Information- Client form.
  • Fill out a Request for Documents- Outside Source form.

For Clients:
  • Fill out a Request for Documents- Guardian-Client form.​
Records Request Forms
AK Crossings Release of Information – Guardian
​Use this form for clients under age 18. Fill out the top, write the name and contact information of the agency or individual in the space provided, and have the guardian AND CLIENT sign/date the bottom of the form.
AK Crossings Release of Information – Client
Use this form for clients age 18 or older. Fill out the top, write the name and contact information of the agency or individual in the space provided, and have the client sign/date the bottom of the form. ​
Request for Documents – Outside Source
Use this form if you are a professional seeking client records, or a parent of an adult client (if you are a parent, leave the field for the agency blank). Be sure to list the specific documents you would like to receive.  The most commonly requested documents include the Assessment, Treatment Plan and Final Report (describes progress towards treatment goals and activities engaged in during the course of the program).
Request for Documents – Guardian and Client
Use this form if you are a client or a guardian of a client (if you are a client, leave the “parent/guardian of” field blank). Be sure to list the specific documents you would like to receive.  The most commonly requested documents include the Assessment, Treatment Plan and Final Report (describes progress towards treatment goals and activities engaged in during the course of the program).
Download:
Fax all Releases of Information and Request for Documents to the attention of the Records Department at 866-223-0888