A standard authorization form for sharing client information with approved parties.
A Release of Information (ROI) allows clients to give written permission for their protected health information to be shared with specific individuals or organizations involved in their care. This form outlines what information may be released, the purpose of the disclosure, and the time frame for authorization.
Having a clear ROI supports ethical practice, HIPAA compliance, and coordinated care. It helps clinicians communicate appropriately with other providers, schools, insurers, or family members while protecting client privacy and maintaining proper documentation.
This file is provided as an editable Word document, so you can customize it to fit your practice needs, state regulations, and branding. You can include it in your intake packet, use it during treatment when coordination is needed, or update it as authorizations change.
A standard authorization form for sharing client information with approved parties.
A Release of Information (ROI) allows clients to give written permission for their protected health information to be shared with specific individuals or organizations involved in their care. This form outlines what information may be released, the purpose of the disclosure, and the time frame for authorization.
Having a clear ROI supports ethical practice, HIPAA compliance, and coordinated care. It helps clinicians communicate appropriately with other providers, schools, insurers, or family members while protecting client privacy and maintaining proper documentation.
This file is provided as an editable Word document, so you can customize it to fit your practice needs, state regulations, and branding. You can include it in your intake packet, use it during treatment when coordination is needed, or update it as authorizations change.
