To be used by providers to link their patients to case management and specialty care. Once signed by the patient, the release of information authorizes the Hotline to receive and share information about the patient and their infant with identified institutions and organizations for the purpose of coordinating follow-up treatment and care.
| Attachment | Size |
|---|---|
| Hotline Release of Information (English)203.37 KB | 203.37 KB |
| Hotline Release of Information (Spanish)196.27 KB | 196.27 KB |