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LICENSING DIVISION (LD)Washington State Department ofCHILDREN, YOUTH & FAMILIESAuthorization and Consent to Share Records Child Placing Agency (CPA) HomeAuthorization and Consent to Share the Records

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How to fill out authorization and consent to

01

Read the authorization and consent form thoroughly to understand what is being requested.

02

Fill out your personal information accurately, such as your name, date of birth, and contact information.

03

Sign and date the form to indicate your agreement and consent to the terms outlined.

04

If applicable, provide any additional information requested on the form.

05

Review the completed form to ensure all required fields are filled out correctly before submitting it.

Who needs authorization and consent to?

01

Authorization and consent forms are typically required by individuals who are participating in a specific activity, event, or program where their consent or agreement is needed.

02

Examples of individuals who may need to fill out authorization and consent forms include participants in research studies, medical patients undergoing treatment, minors participating in school activities, and individuals receiving certain services or benefits.

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What is authorization and consent to?

Authorization and consent refer to the formal permission required from individuals to use or disclose their personal information, often in the context of research or clinical trials.

Who is required to file authorization and consent to?

Researchers, healthcare providers, and organizations conducting studies or trials involving personal data are required to file authorization and consent.

How to fill out authorization and consent to?

To fill out authorization and consent, a standardized form is typically completed, detailing the purpose of data collection, the information being collected, how the data will be used, and obtaining the signature of the participant.

What is the purpose of authorization and consent to?

The purpose of authorization and consent is to protect individuals' rights and privacy by ensuring they are informed and agree to how their information will be used.

What information must be reported on authorization and consent to?

The information that must be reported includes the type of data collected, the purpose of data collection, the duration of data usage, and participants' rights regarding their data.

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