Use this form to authorize the Academic Resource Center to release confidential information. Authorization for Release of Information Academic Resource Center. Use this form to authorize the Academic Resource Center to release confidential information. View / Download PDF. Authorization for Release of Information. DOWNLOAD THIS FORM: Choose a link below to begin downloading. GSA 3590.pdf [PDF - 477 KB]. This is a list of standard government forms that start with the letters 'SF'. Optional Forms (OF).
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This form cannot be used for the re-release of confidential information provided to the Counseling Center by other individuals or agencies. Such requests should. INSTRUCTIONS FOR COMPLETING AUTHORIZATION FOR DISCLOSURE OF PROTECTED HEALTH INFORMATION • NOTE that if an authorization is needed for disclosure of a patient’s medical information for purposes of fundraising or marketing, a separate form is required. Such forms are available at the Marketing & Public Affairs web page of the UW Health intranet.
A patient can consent to the release of health information with this Health Information Release Authorization Form.
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Standard Release Of Information Form Download Pdf
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