While there are circumstances in which the un-consented release of information is legally permitted, it is strongly preferred that consent be obtained from the person designated under the applicable law as controlling third-party access to the information. That person will typically be the minor and/or the minor’s legal guardian, depending on the type of information that is sought. Legal rules governing the content of consent forms vary by jurisdiction and by law, but the following elements are essential characteristics of any consent form. Specifically, the form should:

Identify the individual who the information is about.
Identify the disclosing agency.
Identify (with as much specificity as possible) the information to be disclosed. n Identify the purpose of the disclosure.
Identify the agencies that will receive or access the information.
State the expiration date of the consent or the circumstances under which it will automatically expire or terminate (for example when the youth leaves the court’s supervision with no subsequent oversight).
Describe how a youth, or legal representative can revoke the consent, and state explicitly that the consent is revocable.
State the date consent is given with the signature of the party providing consent.
State that the person whose information is to be disclosed has a right to receive a copy of the consent.

Agencies typically have developed their own consent forms for use in disclosing information. However, in a jurisdiction where multiple agencies are agreeing to share information, it is recommended that the agencies develop a common consent form for use in all situations in which a youth’s information is to be released. Use of a common consent form has several advantages:

It assures that all agencies are using forms that meet legal requirements.
It eliminates debate over the particulars of one agency’s consent form versus another.
It permits consent for multiple disclosures to be made at one time.

No matter what type of consent form is used, a critical complementary step is to establish a protocol for obtaining informed consent from clients. This includes explaining to clients the purpose for seeking the information and for what purpose it will be used. A number of sample consent forms that meet the requirements of multiple laws are provided. A particular jurisdiction of course may want to develop its own form, particularly to assure that the form meets any discrete provisions of that jurisdiction’s law. However, these forms may provide a good place to start the process.

Information sharing project teams may adapt the following sample consent forms for their use:

The Comprehensive Multiagency Consent Form provides for the sharing of information between multiple agencies working collaboratively and within a juvenile/youth assessment environment. The form provides for mandatory disclosures when sharing information such as disclosures for consent periods, revocation limitations, treatment data disclosure limitations and written and verbal authorization and consent requirements. The form also provides the person filling out the form to check the types of information requested under the consent and automatically fills the form with the appropriate disclosures for the information that is being requested. The form can be downloaded at: [Stephanie to provide the link]

The Clark County, Washington Authorization for Disclosure/Release of Information for Protected Health Information (PHI) includes the necessary elements for disclosure of PHI as defined in HIPAA.