Back to Forms & DocumentsReleases / ROI / Authorizations

Release of Information Consent

Authorize PDS to release and obtain information with a person or agency you name. This consent expires automatically twelve (12) months from the date it is signed, unless you revoke it sooner. You may cancel this authorization at any time by notifying PDS in writing.

Your answers are sent privately to PDS staff and are never shown publicly.

Optional but helps us reach them faster.

Information to be released *