Authorization for Release of Information

As summarized in CSAT TAP 18, generally, a program may disclose any information about a client if the client authorizes the disclosure by signing a valid consent form (42 C.F.R. Part 2, § 2.31, 2.33). A consent form under the Federal regulations is much more detailed than a general medical release. It must contain all of the following nine elements. If the form is missing even one of these elements, it is not valid:

1. name of the client;
2. name or general designation of the program making the disclosure;
3. recipient of the information;
• Although the recipient should not be as general as an entire agency or department, it need not be as specific as the name of an individual. Instead, the consent form may describe the recipient's job title and/or job functions.
• It is permissible to list more than one recipient on a single consent form and to authorize disclosures between and among all the parties listed. When doing such multiple-party consents, however, it is important that the "information" and "purpose" and all other elements of the form (see below) be the same for all of the authorized disclosures.
4. purpose of the disclosure;
• The purpose should be narrowly described and should correspond with the information to be released. The purpose should never be as broad as "for all client care."
5. information to be released;
• The information should be described as exactly and narrowly as possible in light of the purpose of the release. Releases for "any and all pertinent information" are not valid;
6. that the client understands that he or she may revoke the consent at any time-orally or in writing-except to the extent that action has been taken in reliance on it;
• A consent for a client referred by the criminal justice system, however, may be made irrevocable for a period of time (§ 2.35). (But note that some State statutes and regulations provide for the automatic expiration of such consents after 60 or 90 days.)
• When a client revokes a consent form, the program is advised to note the date of the revocation clearly on the consent form and to draw an X through the form.
7. date or condition upon which the consent expires, if it has not been revoked earlier;
• Although the Federal regulations do not provide for any time limit on the validity of a consent form, some State laws provide for the automatic expiration of consents after a certain period of time.
8. date the consent form is signed; and
9. signature of the client.