If you are requesting someone else’s records and you have a release or authorization form signed by them, please upload it here.
Privacy laws restrict certain information from being released without permission. Authorization forms allow for the release of protected information to a person or organization that you choose.
Click here to download authorization form. Right click and save on PC then fill out and attach to this request and open the form in Acrobat Reader to complete. If using your Mac Magic Trackpad or built-in Multi-Touch trackpad, click or tap with two fingers. On Mac computers, right click is known as secondary click or Control click. If your mouse, trackpad, or other input device doesn’t include a right-click button or other way to perform a right click, just hold down the Control key on your keyboard while you click.
If you are requesting the release of an individual’s confidential records, such as medical or employment records, DHS must receive a signed authorization from the individual.