4.2.1.1 Requesting Confidential Information

When requesting confidential information, the FEP must use the Authorization for Disclosure of Confidential Information form (10779) .

This form meets federal and state requirements for the confidential release of information from treatment providers, including:

AODA Alcohol and Other Drug Abuse treatment;

Mental health treatment;

Domestic violence counseling;

HIV/AIDS; and

Medical conditions.