Authorization for Release of Data

As part of the AccessKC registration process, you will be asked to waive your rights under HIPAA so we can communicate with the vendor(s) you select to provide the service(s) you need. The online registration offers a simplified Authorization for Release of Data. To review and execute a more formal authorization and consent for information, download the form below. After you print and physically sign the form, email it to Administration@AccessKC.org.