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Click ‘Get Form’ to open the eau waiver form in the editor.
In Section A, provide your personal information including your full name, date of birth, student ID number, and daytime phone number. Ensure all details are accurate for proper identification.
Move to Section B where you will list the third-party designee(s). Enter their full names and relationships to you. You can add multiple designees if necessary.
In Section C, specify the information you wish to disclose. Be clear about what records you are allowing access to.
Section D requires you to state the purpose for disclosure. This helps clarify why this information is being shared.
Finally, in Section E, read the certification statement carefully. Sign and date it to authorize the release of your records as specified.
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