~lahsa-confidential
What information can be released by LAHSA or the Covered Program?
Will withdrawing consent affect LAHSA or the Covered Program's ability to disclose personal information?
Can LAHSA or the Covered Program control what happens to the released information?
What happens if the information is shared with others by the agency or person it was released to?
What are the risks and benefits of releasing the confidential information?
What are the potential risks of the method by which the information will be released?
What information should be provided in the release form?
What is the purpose of this release form?
Is there a limit to the information that can be released?
Can the consent to release information be withdrawn?
Can I refuse to sign or give verbal consent to this release?
What is the purpose of the Revocation of Authorization form?
Where should the Revocation of Authorization form be mailed or delivered?
What is the expiration date of the release?
What should I do if additional time is necessary to meet the purpose of this release?
