Confidential Information Releases

This Authorization to Release Confidential Information will ensure that only the information you specify is released on your behalf. This authorization can be given to a physician, attorney, hospital, clinic or school to release confidential information on your behalf. The types of confidential information to be released can vary from financial, educational and legal to your social interactions, both online and in person. This Authorization to Release Confidential Information is beneficial because it protects not only your privacy but contains an expiration date and can be revoked at any time. (continued ...)