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1301 Eagle Avenue Washington, IL 61571 Phone: (309× 4443943 Fax: (309× 4449898 Website: www.central51.net AUTHORIZATION TO RELEASE OR SECURE STUDENT RECORDS I authorize (previous school):, located
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How to fill out authorization to release or
How to fill out authorization to release:
01
Start by writing your personal information: Include your full name, address, date of birth, and contact information. This information is necessary to identify you as the individual authorizing the release of information.
02
Specify the recipient: Indicate the name, organization, or entity to whom you are giving authorization to release your information. Be clear and provide accurate details to ensure the proper party receives the authorization.
03
State the purpose of the release: Clearly explain why you are providing the authorization to release your information. Whether it is for medical records, educational records, or any other specific purpose, be specific in your statement.
04
Sign and date the form: To make the authorization official, sign and date the form. This signifies your consent and understanding of the release of your information.
Who needs authorization to release:
01
Patients in healthcare settings: Individuals receiving medical treatment may need to authorize the release of their medical records to other healthcare providers, insurance companies, or legal entities.
02
Students or former students: Educational institutions often require authorization from students or former students to release their academic records, transcripts, or disciplinary records to potential employers, other educational institutions, or government agencies.
03
Legal matters: Individuals involved in legal proceedings, whether it's civil or criminal, may need to give authorization to release their records to attorneys, courts, or other relevant parties involved in the case.
04
Consent for minors: Parents or legal guardians may need to provide authorization to release their child's records or information to educational institutions, healthcare providers, or other relevant parties.
It is important to note that the specific requirements for authorization to release may vary depending on the jurisdiction, organization, or situation. It is advised to carefully read and follow any instructions provided on the authorization form to ensure compliance.
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