This Authorisation to Release Confidential Information will ensure that only specified information is released on your behalf. This authorisation can be provided to a physician, attorney, hospital, clinic or school. The confidential information to be released may vary from financial, educational and legal to your social interactions, both online and in person. This Authorisation is beneficial because it protects not only your privacy but contains an expiration date and can be revoked at any time.

These important provisions are included in this Authorisation:

• Authorisation Information: Indicates the name and address of the individual authorising release of the information and the individual or entity who will release the confidential information;
• Types of Confidential Information: Sets forth a checklist covering most types of confidential information;
• Purpose of Use: Outlines the purposes the confidential information may be used for;
• Revocation and Expiration Dates: This Authorisation may be revoked at any time or on a specified expiration date.

Protect yourself and your rights by using our professionally prepared up-to-date forms.

This lawyer prepared packet includes:

1. General Information
2. Instructions and Checklist
3. Authorisation to Release Confidential Information for England and Wales

Law Compliance: This form complies with the laws of England and Wales