Form HEA8019 Authorization to Release Information - Help Me Grow Home Visiting - Ohio

What Is Form HEA8019?

This is a legal form that was released by the Ohio Department of Health - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form HEA8019?
A: Form HEA8019 is the Authorization to Release Information for the Help Me GrowHome Visiting program in Ohio.

Q: What is the Help Me Grow Home Visiting program?
A: The Help Me Grow Home Visiting program is a program in Ohio that provides support and resources to families with young children.

Q: Why do I need to fill out Form HEA8019?
A: You need to fill out Form HEA8019 to authorize the release of information related to your participation in the Help Me Grow Home Visiting program.

Q: What information can be released with Form HEA8019?
A: With Form HEA8019, you authorize the release of information such as your personal information, medical information, and educational information.

Q: Who can access the information released with Form HEA8019?
A: The information released with Form HEA8019 can be accessed by authorized individuals involved in the Help Me Grow Home Visiting program, including program staff and contractors.

Q: How long does the authorization on Form HEA8019 last?
A: The authorization on Form HEA8019 is valid for 24 months from the date it is signed, unless you specify a shorter period.

Q: Can I revoke the authorization on Form HEA8019?
A: Yes, you have the right to revoke the authorization on Form HEA8019 at any time by submitting a written request.