The release of information document must include the:
(1) name of no more than one person or organization to which the information is being released;
(2) specific information to be released;
(3) beginning and ending dates the release is effective, not to exceed the program participant's active length of services;
(4) date and the signatures of the program participant and the employee or volunteer; and
(5) right to revoke a release of information at any time. This revocation request must be submitted in writing.
Source Note: The provisions of this §379.2019 adopted to be effective December 23, 2007, 32 TexReg 9335