Client Information and Release Form

Form Template

The Client Information and Release Form mobile app was designed to give emergency services staff the authorization to release information about a disaster victim and his or her family after a disaster has occurred.

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While this client consent form was designed for use by the American Red Cross, it can be customized for use by any organization that provides emergency services.

The authorization to release form records the victim's current and previous address, contact details, and personal information. Once the agreement is complete and each party gives their consent by providing their electronic signature, the release and client intake form can be shared and stored electronically.

Need something different? Check out our informed consent form app.

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