Get Authorization To Furnish Information Autorizaci N Para Dar Informaci N - Dads State Tx

Filling out the Authorization To Furnish Information form is crucial for allowing the Texas Health and Human Services Commission to gather pertinent information regarding eligibility for assistance. This guide will provide a clear and structured approach to completing the form online, ensuring all necessary fields are addressed accurately.

Follow the steps to complete the form effectively.

1. Press the ‘Get Form’ button to access the Authorization To Furnish Information form. This action allows you to open the document in your preferred online editing tool, ready for completion.
2. Begin filling out the form by entering the name of the applicant or recipient in the designated field, where indicated as 'Name of Applicant or Recipient'. This information is essential to identify who is authorizing the release of information.
3. If applicable, provide the name of the spouse in the specified field labeled 'Name of Spouse'. This section is important if the applicant or recipient has a spouse whose information might be relevant.
4. In the next section, enter the residential address in the 'Address/Dirección' field. Make sure the address is fully accurate as it may be used for communication.
5. Review the authorization statement carefully. This statement authorizes various individuals and organizations to share relevant information with the Texas Health and Human Services Commission, while explicitly stating exceptions regarding personal health information.
6. Sign the document where indicated as 'Signature – Applicant or Recipient'. This signature confirms that you authorize the information exchange as described.
7. Include the date of signature next to your signature, ensuring all signed documents are dated appropriately.
8. If applicable, have the spouse sign in the 'Signature – Spouse' area, along with the date of their signature.
9. If you are a guardian, power of attorney, or parent of a minor child, sign in the respective section labeled 'Signature – Guardian, Power of Attorney, Parent of Minor Child', and add the date next to your signature.
10. Once all fields are filled and signatures are added, you can save the document, download it for your records, print a physical copy, or share it directly as needed.

Complete your Authorization To Furnish Information form online today for efficient processing.