1. Third Party Authorization: Section to be included when authorization is being given to release information to a third party, such as a potential employer or government agency

2. Interpreter Declaration: Required when the form has been explained to the individual through an interpreter

3. Agent Authorization: To be included when a legal representative or authorized agent is acting on behalf of the individual

4. Revocation Terms: Optional section outlining the process and terms for revoking the authorization

5. Additional Contact Information: Secondary contact details section, used when alternative contact persons need to be listed

1. Identity Verification Documents: List of acceptable identification documents and copies required to be attached to the form

2. Privacy Policy Summary: Summary of relevant privacy policies and information handling practices

3. Document Checklist: Checklist of all required documentation and information to be submitted with the form