Release of Information

What is an ROI?

An ROI or Release of Information, is a legal document that gives your provider permission to release your personal health/service information that you designate to family members, friends, health care providers or other 3^rd parties as specified by you. Collaborating with other professionals (examples: doctors, therapists, social workers, etc.) and natural supports (examples: parents, siblings, spouses, friends, etc.) is essential in providing the best possible services to you or your family members. An ROI allows for communication regarding your health information for purposes specified on the form.

Why is an ROI necessary?

An ROI is necessary because your personal health information is confidential and is protected by the Health Insurance Portability and Accountability Act, or HIPAA, and without an ROI, any individual requesting your information would not be privy, by law, to any of your personal information, with few exceptions. An ROI is generally valid for one year from the date signed but it may also be revoked at your discretion at any time.

Return the completed ROI by mail to:

Sauk County Department of Human Services
Attention:  Records
P. O. Box 29
Baraboo, WI  53913

Or by fax to:

(608) 355-4294