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This version of the form is not currently in use and is provided for reference only. Download this version of
Form 11
for the current year.
Form 11 Consent for Release of Confidential Health and / or Mental Health Information - Virginia
What Is Form 11?
This is a legal form that was released by the Virginia Department of Corrections - a government authority operating within Virginia. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 11?A: Form 11 is a consent form for the release of confidential health and/or mental health information.
Q: What is the purpose of Form 11?A: The purpose of Form 11 is to give consent for the release of your confidential health and/or mental health information.
Q: Who needs to fill out Form 11?A: Anyone who wants to authorize the release of their confidential health and/or mental health information needs to fill out Form 11.
Q: Can I use Form 11 in Virginia?A: Yes, Form 11 is specifically for use in Virginia.
Q: Is there a fee to use Form 11?A: There is no fee to use Form 11.
Form Details:
- Released on January 27, 2021;
- The latest edition provided by the Virginia Department of Corrections;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form 11 by clicking the link below or browse more documents and templates provided by the Virginia Department of Corrections.
