Get University Of Nevada Las Vegas Authorization For Disclosure Of Personal Information 2017-2025

Filling out the University Of Nevada Las Vegas Authorization For Disclosure Of Personal Information form online is an essential step for users seeking to authorize the release of their personal information. This guide provides clear, step-by-step instructions to ensure that you complete the form accurately and efficiently.

Follow the steps to complete your disclosure authorization form

1. Click ‘Get Form’ button to access the Authorization for Disclosure of Personal Information form and open it in the editor.
2. Fill in your name in the designated field. Ensure that the name matches the legal name on your records.
3. Enter your NSHE number in the appropriate field, which is essential for identification purposes.
4. Provide your Rebel Mail address, which will be used for communications regarding your authorization.
5. Input your phone number for contact purposes to keep you informed about the status of your request.
6. In the section labeled ‘I HEREBY AUTHORIZE INFORMATION TO BE RELEASED’, fill in the details of the sender and receiver of the information. For the sender, you can leave it as the current institution unless specified otherwise.
7. Under ‘TO:’, specify the UNLV Disability Resource Center information, including their address and contact numbers as stated in the form.
8. Complete the fields for the agency or person authorized to receive your information, including name, address, phone number, and email address.
9. If you wish to allow mutual disclosure between the listed agencies or persons, check the appropriate box.
10. Indicate the purpose for the release of information in the corresponding field; be as clear and concise as possible.
11. Review the categories of information to be released and initial each line to authorize the release of specific information.
12. Select your consent preferences regarding faxing and emailing your information by checking ‘Yes’ or ‘No’ for each method.
13. Read the consent statement regarding confidentiality and ensure you understand the terms before proceeding.
14. Date the authorization in the provided field and sign the document in the presence of a Disability Resource Center Official.
15. A witness must also sign the document, recording their name and date as required.
16. Once completed, save your changes, download, print, or share the form as needed.

Begin completing your University Of Nevada Las Vegas Authorization For Disclosure Of Personal Information online today.