Jun 13, 2013 · This document is a client authorization for releasing information to legal counsel. To save files, right click and choose 'Save Target As' or 'Save Link As'. Attachment. Size. Attachment. Size. English - Authorization for Release of Information.doc. 24.5 KB. Spanish - Authorization for Release of Information.doc.
Attorney Release Form. Authorization to release criminal history record information, Voluntary Appeal File (VAF) results and release of liability. To print the document, click the "Original ...
I080 Nimitzview Dr. Ste. 400 Cincinnati, OH 45230 Tel (5I3) 624-3900 Fax (5I3) 624-3909. Client Authorization to Share Information (Release of Information) . This form authorizes the release and sharing of individual information which includes: prior year tax returns and supporting document associated with those tax returns, as well as personal information such as name, birth date, …
With few exceptions, social workers are generally advised to release confidential client information only with a written release signed by the client or their authorized representative (such as the parent of a minor, guardian, etc.). The release form typically describes the scope of the information requested, which may vary considerably.
In any situation where a client’s record is to be released, it is the social worker’s obligation to ensure that the client’s consent is fully informed. In order to accomplish this, the client needs to be fully aware of the content of the record that is to be disclosed. It is not unusual for clients to have little awareness of the information that has been documented in the course of therapeutic sessions. After a discussion or review of the contents of the clinical record with the social worker, the client will be in a better position to determine whether to agree to a potential release of information or to revoke an authorization that they may have already signed (Reamer, p. 54 – 56, 2006).
If a client objects to a subpoena, a social worker may need additional assistance such as consultation with an attorney in order to file a motion to quash (or block) the subpoena. Resources available to NASW members include a risk management hotline (available through NASW Assurance Services, Inc. at 800-897-0033), ethics consultations with the Office of Ethics & Professional Review (available Tuesdays, 10 a.m. – 1 p.m. and Thursdays, 1 p.m. - 4 p.m., Eastern Time, at 800-638-8799, Ext. 282) and legal consultations available from the Office of General Counsel/Legal Defense Fund (800-638-8799, Ext. 290). In addition, NASW members who have the NASW ASI professional liability insurance may have coverage for legal consultation related to the receipt of a subpoena for client records. Confirmation of coverage can be obtained by calling the ASI 800 number above.
subpoena is a special type of request for client information, usually issued by an attorney representing a party in a legal matter. Similar issues concerning the client’s informed consent apply to subpoenas. This is addressed in an earlier Legal Issues of the Month article, Responding to a Subpoena (Morgan & Polowy, 2009). When a social worker has received a subpoena, it is important to note which party is requiring the disclosure of information: Is it the client (through their attorney) or the opposing party? Additional caution and review are required when responding to subpoenas from opposition counsel, as an improper or unauthorized release of information could have a lasting and damaging impact on the client’s legal matter and be a potential basis for a malpractice complaint against the social worker.
If you feel you were improperly represented, it’s in your best interest to hire a new attorney. Many people often feel their hired attorney doesn’t have their best interests at heart.
Formally address the letter the same as you would any other standard letter by including your name, address, and the date along with the attorney’s name and address as well.
For this particular kind of letter, get straight to the point in the first paragraph. Convey that you desire to fire the attorney and the reasons why. State the reasons why you feel the need to fire their organization without making excuses.
In the third and final paragraph, thank the firm for their services in addition to the time they spent on your case.
Below are samples of an attorney termination letter. It should state the intent to terminate the attorney’s services effective immediately upon receipt of the letter.
It has become necessary for my business to employ a larger law firm. Since we have grown, it has become apparent that we need ethics compliance advice.
This letter is formal confirmation of our discussion today about your termination of services for this company. As mentioned in the meeting, two departments are combining and your services will no longer be required.
In addition, any person that has been appointed by a court to act as a caregiver or guardian, the judgment, order, or decree must be attached to the HIPAA release form.
Accessing and obtaining your medical records is a requirement under 45 CFR 164.524 which requires that any request made to access or transfer medical records must be completed within 30 days or a letter must be sent to the requestor stating why the records are delayed.
An adult or legal guardian is legally authorized, under federal law, to obtain the medical records of a minor. If the medical records are for healthcare services that will be provided, the minor may be required to consent to such care based on State law.
The medical facility may charge a fee for sending the records, although, they are prohibited from charging for processing the request.