Sfn 1059-2025

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4.8 out of 5

70 votes

The document is an 'Authorization to Disclose Information' form from the North Dakota Department of Human Services, which allows clients to authorize the disclosure of their health information. It includes sections for client identification, details about the information to be disclosed, reasons for disclosure, and consent requirements. The form emphasizes the voluntary nature of authorization, privacy rights regarding social security numbers, and specific protections for substance use disorder information.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (70 Votes)
2003	4 Satisfied (24 Votes)

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