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Release of Information Consent Form (Minors)I (Parent name), authorize you to release information regarding (client name), (DOB) authorize Ellie Family Services to:Disclose to:Obtain from:Exchange
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The release of information consent form for minors is a legal document that allows a parent or legal guardian to authorize the disclosure of a minor's protected health information.
Parents or legal guardians of minors are required to file the release of information consent form for minors.
The release of information consent form for minors can typically be filled out by providing the minor's personal information, the authorized recipient of the information, and the specific information to be disclosed.
The purpose of the release of information consent form for minors is to ensure that a minor's protected health information is only disclosed with the consent of a parent or legal guardian.
The release of information consent form for minors usually requires information such as the minor's name, date of birth, the specific information to be disclosed, and the duration of the consent.
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