This Release of Information does not authorize the disclosure of any medical information or any other restricted third-party information. I understand that this information will be used to determine eligibility for employment and training services, will assist in the development of my individual training plan for education and/or employment, and will be used for statistical purposes.
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I allow this website and the identified system partners to release to each other the requested information when I am referred to partner services. I understand the information will be used only on an as needed basis and will remain confidential, to the extent required and/or permitted by law.

This information cannot be shared with any other entity without my written permission. A copy of this Release of Information is as valid as the original. This Release is valid for both program and follow-up services.