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Massachusetts Department of Public Health. Authorization for Release of Information.If you need help completing the MassHealth Authorization to Release Protected Health Information, call a. DES representative at (800) 888-3420. Telephone Number: AUTHORIZATION FOR RELEASE OF PROTECTED. Complete this form only if you want us to give information or records about you, a minor, or a legally incompetent adult, to an. If you want to authorize release of information to more than one person, you must complete a separate form for each person. See detailed instructions for completing the ROI Form on page 3. 1. Member wants to authorize release of health information to their attorney:. Patient privacy is a priority at St. Elizabeth's Medical Center.