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4814.4528.9736 intercollegiate athletic program: authorization and consent to disclosure of protected health information by: Natasha baker, Esq.

How to fill out 16-17studentathlete consent for disclosure

How to fill out 16-17 student athlete consent for disclosure:

1. Obtain the 16-17 student athlete consent for disclosure form from the appropriate source, such as your school's athletic department or the organization overseeing the athletic program.
2. Fill in your personal information, including your full name, date of birth, and contact information. Make sure this information is accurate and up to date.
3. Provide any relevant information related to your sports participation, such as the sport you are involved in, your team, and your coach's name.
4. Read through the consent for disclosure section carefully. This section typically outlines the specific information that may be disclosed, such as your academic records, medical history, and photographs/videos. If you have any concerns or questions, reach out to the appropriate authority for clarification.
5. Sign and date the form, indicating that you understand and agree to the disclosure of the specified information. If you are under the age of 18, a parent or legal guardian will also need to sign the form.
6. Return the completed form to the designated authority, ensuring that it is submitted before any applicable deadlines.

Who needs 16-17 student athlete consent for disclosure:

1. Student athletes aged 16 to 17 who are participating in organized sports programs typically need to provide consent for disclosure.
2. This may be required by educational institutions, athletic departments, or sports organizations to ensure compliance with privacy laws and to facilitate the sharing of necessary information related to the student athlete's participation.
3. It is important to check with your specific institution or organization to determine if this consent is required and if there are any additional steps or forms necessary for compliance.

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