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RELEASE OF INFORMATION FORM
Student Consent Form for Disclosure of Information to ParentsUnder the Family Educational Rights and Privacy Act (FER PA), Great Lakes Christian College is
permitted to
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What is release of information form?
A release of information form is a document that authorizes the disclosure of protected health information to a specific individual or entity.
Who is required to file release of information form?
The individual seeking the release of information is required to fill out and file the form.
How to fill out release of information form?
To fill out a release of information form, the individual must provide their personal information, specify the information to be released, and sign the form.
What is the purpose of release of information form?
The purpose of a release of information form is to ensure that protected health information is disclosed only to authorized individuals or entities.
What information must be reported on release of information form?
The release of information form must include the individual's name, date of birth, the information to be disclosed, the recipient of the information, and the purpose of the disclosure.
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