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JV-226Optional

Authorization to Release Health and Mental Health Information

California · Judicial Council of California · Effective July 1, 2013

This form lets a parent, legal guardian, or the child give permission for the release of the child's health and mental health records to a child welfare agency. It allows the agency to help the child get services and manage care.

The court describes it as: A parent or legal guardian uses this to authorize the release of the child’s health and/or mental health records to the child welfare agency to make sure that the child receives good services.

Open the official PDFfrom Judicial Council of California

Where this fits in a case

General & info

Information / general use — not tied to one step of a case

This form is used when a child welfare agency needs to access a child's medical or mental health records to ensure the child receives necessary services.

Either party may file.

Official instructions

How-to guides published by the court for this form.

Common questions

Who can fill out this form?
A parent, legal guardian, or the child can complete this form, depending on the section being filled out.
Does signing this form mean the child can't get treatment if I change my mind?
The form states that the child cannot be denied treatment just because the parent or guardian chooses not to sign.

Revision history

No changes recorded since we started tracking this form on October 9, 2026. The current version took effect July 1, 2013.

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