Helpful Hints for Valid Release of Information

  • Print the Client Name and Date of Birth clearly
  • If there are Yes and No boxes, one of them must be marked
  • If there is a line intended for an expiration date, please fill it in, otherwise it will be one year from the date signed
  • Make sure that the client and/or legal guardian has signed and dated the release
  • Please include any contact information for the person requesting the information