ELECTRONIC DATA RELEASE AGREEMENT - Azzule Systems: Fill out & sign online

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Click ‘Get Form’ to open the ELECTRONIC DATA RELEASE AGREEMENT in the editor.
Begin by filling in the name of your company in the designated area where it states 'permits Azzule Systems'. This identifies who is granting permission for data transfer.
List the organizations that will receive access to electronically stored data. Fill in each organization’s name under 'Extranet owning organization' as applicable.
Review the section regarding data coverage. Ensure you understand that this agreement covers all past and future data unless retracted in writing.
Sign and date the document in the provided fields. Make sure to print your name clearly beneath your signature.
Once completed, scan the signed copy and email it to securesites@azzule.com as instructed.

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