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Supported Decision-Making Release of Confidential Information – Sample Form

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Supported Decision-Making Release of Confidential Information – Sample Form

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When an individual with a disability enters into a Supported Decision-Making Agreement, the individual may authorize the release of confidential information to their supporter. This may be done so the supporter can help the individual understand their confidential information and/or help the individual communicate their decisions. Information could be related to health, education, employment, finances, and more. To initiate the release of confidential information, an individual with a disability and their supporter can get started by completing a form like the sample included below.

Created: March 9, 2016
Publication Code: SDM03




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