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UNIVERSITY OF WISCONSIN-MADISON UNIVERSITY HEALTH SERVICES HIM (Medical Records) 333 East Campus Mall, Rm 8102 ×8104 Madison, WI 53715-1381 Phone: (608) 262-1676 Fax: (608) 262-9160 1. Regarding

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What is authorization for release of?

Authorization for release of is a legal document that grants permission for the release of specific information or records to a designated entity or individual.

Who is required to file authorization for release of?

The individual or entity requesting the release of information is required to file an authorization for release of.

How to fill out authorization for release of?

To fill out an authorization for release of, you need to provide your personal information, specify the information or records you want to release, state the purpose of the release, and sign the document.

What is the purpose of authorization for release of?

The purpose of authorization for release of is to ensure that individuals have control over the disclosure of their personal information and to protect their privacy rights.

What information must be reported on authorization for release of?

The information that must be reported on an authorization for release of includes the requester's name, contact information, the specific information or records being released, the purpose of the release, and any relevant dates.

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