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2401 Stanley Fault Parkway, Louisville, KY. 40223 Patty Ernst, 7360800 ext 100 or 7419878 Ernst midamericasportscenter.com2017 JAMBOREES FOR ELEMENTARY & MIDDLE SCHOOL TEAMS THERE IS NO ENTRY FEE

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What is release of information authorization?

Release of information authorization is a legal document that allows the disclosure of an individual's protected health information to specified entities or persons.

Who is required to file release of information authorization?

Any individual who wants to release their protected health information to specific entities or persons is required to file a release of information authorization.

How to fill out release of information authorization?

To fill out a release of information authorization, one must provide their personal information, specify the recipient of the information, and sign the authorization form.

What is the purpose of release of information authorization?

The purpose of release of information authorization is to ensure that an individual's protected health information is disclosed only to authorized parties and for specified purposes.

What information must be reported on release of information authorization?

The release of information authorization must include the individual's personal information, the recipient of the information, the purpose of disclosure, and any limitations on the disclosure.

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