Release of Info Authorization 04 18 DOCX Form

What is the Release Of Info Authorization 04 18 document?

The Release Of Info Authorization 04 18 document is a formal authorization form used in Michigan to allow the sharing of personal information between designated parties. This document is crucial for individuals who need to grant permission for their medical, financial, or other sensitive information to be disclosed. Understanding the specific purpose and implications of this authorization is essential for ensuring compliance with privacy laws.

Key elements of the Release Of Info Authorization 04 18 document

This authorization form includes several key elements that must be clearly defined for it to be valid. These elements typically include:

• Identifying Information: The full name, date of birth, and contact details of the individual granting permission.
• Recipient Information: Details of the person or organization authorized to receive the information.
• Scope of Authorization: A clear description of what information can be shared and for what purpose.
• Expiration Date: The duration for which the authorization is valid, after which it becomes void.
• Signature: The signature of the individual granting the authorization, which must be dated.

Steps to complete the Release Of Info Authorization 04 18 document

Completing the Release Of Info Authorization 04 18 document involves several straightforward steps:

1. Download the Form: Obtain the official Release Of Info Authorization 04 18 document from a reliable source.
2. Fill in Personal Information: Enter your full name, date of birth, and contact details accurately.
3. Specify the Recipient: Clearly identify who will receive your information, including their contact details.
4. Define the Scope: Outline what specific information you are authorizing to be shared and the purpose of this sharing.
5. Set Expiration: Indicate how long the authorization will remain valid.
6. Sign and Date: Provide your signature and the date of signing to validate the document.

Legal use of the Release Of Info Authorization 04 18 document

The legal use of the Release Of Info Authorization 04 18 document is governed by various privacy laws, including HIPAA for medical information. For the authorization to be legally binding, it must meet specific requirements, such as obtaining informed consent from the individual. This ensures that the individual is aware of what information is being shared and with whom, safeguarding their rights and privacy.

Examples of using the Release Of Info Authorization 04 18 document

There are numerous scenarios where the Release Of Info Authorization 04 18 document can be utilized effectively, including:

• Medical Records: Allowing a healthcare provider to share your medical history with another doctor or specialist.
• Financial Information: Authorizing a bank to disclose account details to a financial advisor.
• Educational Records: Permitting a school to release academic records to a college or university.

Who issues the Release Of Info Authorization 04 18 document?

The Release Of Info Authorization 04 18 document is typically issued by healthcare providers, educational institutions, or financial organizations that require consent to share personal information. It is essential to ensure that the form is obtained from a legitimate source to maintain its validity and compliance with applicable laws.