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RELEASE OF INFORMATION FORM Applied Psychological Services, Inc. Caroline Levitt, Ph.D.1001 Weather stone Parkway Suite 430 Woodstock, Georgia 3018 Business: (770) 5920150 Facsimile: (770) 5920971Ashley
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How to fill out release consent form

01
Fill in your personal information such as name, address, date of birth, etc.
02
Specify the purpose for which you are giving consent to release information.
03
Provide details of the information that will be released.
04
Sign and date the form to indicate your consent.
05
Make a copy of the completed form for your records.

Who needs release consent form?

01
Anyone who is required to release their personal or confidential information to a third party, such as medical professionals, legal representatives, employers, etc., may need a release consent form.
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Release consent form is a document that allows an individual or organization to give permission for the release of certain information or records.
Individuals or organizations who wish to authorize the release of specific information or records are required to file a release consent form.
The release consent form typically requires the individual to provide their name, contact information, the information they are authorizing for release, and their signature.
The purpose of a release consent form is to obtain permission to release specific information or records to a designated party.
The release consent form must include details such as the type of information being released, the purpose of the release, and the recipient of the information.
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