Release of Information – Early Intervention Fillable PDF
Authorization to release information forms must be submitted to: RecordsRequests@butlerdd.org
Our offices will be closed on Friday, July 4, in observance of Independence Day.
A person who receives services from our Board is an “enrollee.” All information contained in an enrollee’s record, including what is retained or transmitted electronically and verbally shall be considered confidential. The Board shall not use or disclose Protected Health Information (PHI), beyond what is otherwise permitted or required by law, without a signed authorization in accordance with Board procedures.
Authorization to release information forms must be submitted to: RecordsRequests@butlerdd.org