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DEPARTMENT OF HEALTH SERVICES STATE OF WISCONSIN F82009 (07/2008)Sections 19.35 & 19.36, Wis. Stats.CONFIDENTIAL INFORMATION RELEASE AUTHORIZATION Completion of this form authorizes the release of
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How to fill out confidential information release authorization

01
Obtain the correct form for the confidential information release authorization.
02
Fill in your personal information, including your full name, contact information, and date of birth.
03
Specify the information that you are authorizing to be released, such as medical records or financial information.
04
Include the name of the individual or organization that is authorized to release the information.
05
Sign and date the form to confirm your authorization.
06
Submit the form to the relevant party, such as a healthcare provider or financial institution.

Who needs confidential information release authorization?

01
Individuals who require someone else to access their confidential information on their behalf.
02
Legal representatives who need to obtain confidential information for a specific legal purpose.
03
Companies or organizations that need to share confidential information with third parties for business purposes.

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Confidential information release authorization is a form or document that allows an individual or organization to authorize the release of sensitive or private information to a specific party.
Individuals or organizations who possess confidential information and wish to disclose it to another party are required to file a confidential information release authorization.
To fill out a confidential information release authorization, one must provide their personal details, specify the information being released, identify the recipient, and sign the authorization form.
The purpose of confidential information release authorization is to ensure that sensitive information is only disclosed to authorized individuals or entities and to protect the privacy and confidentiality of the information.
The information that must be reported on a confidential information release authorization includes the nature of the information being released, the reason for the release, and the identity of the recipient.
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