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This authorization is valid until I revoke it or 60 days after I have completed treatment, whichever is sooner. Instructions for completing the Authorization for the Release of Confidential Information. 1.Information to be released (PLACE YOUR INITIALS TO THE LEFT OF EACH ITEM APPROVED):. Purpose and Laws: This form, when properly completed, permits the release of confidential information about a person receiving services. This authorization includes information placed in my record after the date of my signature and before the expiration of my consent. Signature of ALF Resident. A. Specify the records to be released. All sections of this authorization form MUST be completed to be considered valid. AUTHORIZATION TO RELEASE CONFIDENTIAL INFORMATION, Client Name. Michigan Department of Health and Human Services.