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MESA Revised 9×28/15-Page 1 of 2 AUTHORIZATION FOR USE×DISCLOSURE OF PROTECTED HEALTH INFORMATION HOUSING ASSISTANCE PROGRAM COUNTY OF LOS ANGELES DEPARTMENT OF MENTAL HEALTH I authorize the use
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How to fill out authorization for success stories

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How to fill out authorization for success stories:

01
Start by gathering all necessary information about the success story, such as the names and contact information of the individuals involved, their company or organization, and specific details about their achievements.
02
Clearly state the purpose of the authorization form, which is to obtain consent from the individuals involved to use their success story for promotional or marketing purposes.
03
Include a section where the individuals can indicate their level of approval for the use of their success story. This could range from granting full permission to use their name, image, and story in any media, to allowing only specific portions of their story to be shared.
04
Provide a space for the individuals to sign and date the authorization form, indicating their agreement to the terms outlined.
05
Include a section for any additional comments or stipulations that the individuals may have regarding the use of their success story.
06
Clearly communicate the next steps after the form is completed, such as how the success story will be used and who will have access to it.
07
Keep a copy of the signed authorization form for your records, and ensure that the individuals are provided with a copy as well.

Who needs authorization for success stories?

01
Individuals who have had their success stories featured or documented.
02
Companies or organizations that wish to use the success stories for promotional or marketing purposes.
03
Anyone who wants to ensure that the use of their success story is done with their consent and in a manner that aligns with their wishes.
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Authorization for success stories is a form that grants permission to share personal or business success stories in marketing materials.
Anyone who wishes to use success stories for promotional purposes should file authorization before sharing the stories.
Authorization for success stories can be filled out by providing personal or business information, details of the success story, and specifying how the story will be used.
The purpose of authorization for success stories is to ensure that individuals or businesses have consented to the use of their success stories in marketing materials.
Information such as name of the individual or business, details of the success story, purpose of sharing the story, and any restrictions on the use of the story must be reported.
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