Get Il Client Informed Consent Authorization For Release Of Information - Kane County 2018-2025

Completing the IL Client Informed Consent Authorization For Release Of Information is a crucial step for individuals seeking support through the Kane County Continuum of Care. This guide will provide you with clear, step-by-step instructions on how to fill out this form online, ensuring that you understand each section and its purpose.

Follow the steps to complete the form accurately.

1. Start by locating the ‘Get Form’ button to access the document. Once you press this button, the form will open in your preferred online editor, ready for you to fill out.
2. Begin filling in your personal information by entering your full name in the designated field labeled 'CLIENT NAME'. Ensure this is completed accurately to avoid any issues with information processing.
3. In the next field, provide your social security number. This information is crucial for identifying you in the system while maintaining confidentiality during the data sharing process.
4. Continue by entering your date of birth. This detail helps confirm your identity and eligibility for services offered through the Kane County Continuum of Care.
5. In the section titled 'I hereby authorize', fill in the name of the agency that you are granting authorization to. This should be a participating member of the Kane County Continuum of Care.
6. Review the list of information that may be disclosed. Initial next to any information that you do not wish to share, such as name, social security number, or other personal identifiers.
7. Make sure to read through the consent statements carefully. Understanding these provisions is important as they outline your rights regarding data sharing and consent revocation.
8. If you have dependent children under 18 living with you, list their first and last names in the provided space to include them in this consent as well.
9. After completing the form, ensure to sign and date the consent section. If applicable, a second adult must also provide their signature and date.
10. Finally, a witness must sign and date the form. This step verifies that the consent process was observed correctly. Once all fields are filled, save your changes, and you may choose to download, print, or share the completed form as necessary.

To ensure smooth processing, complete your documents online today.