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Library: Policy

340:75-1-46. Transfer and release of confidential information with the standard Consent for Release of Information form

Revised 7-1-13


(a) As mandated in 10 O.S. § 620.1 – 620.4, a uniform form, Form 04MP001E, Consent for Release of Information, was developed by the agencies listed in paragraph (1) of this subsection to be utilized when requesting confidential information from each of these agencies.

  • (1) Agencies mandated to develop and use the uniform Consent for Release of Information are the:

    • (A) Oklahoma Department of Human Services (OKDHS);

    • (B) Department of Mental Health and Substance Abuse Services;

    • (C) State Department of Health;

    • (D) State Department of Education;

    • (E) State Department of Vocational and Technical Education;

    • (F) Oklahoma Commission on Children and Youth;

    • (G) J.D. McCarty Center for Children with Developmental Disabilities;

    • (H) Department of Corrections; and

    • (I) Office of Juvenile Affairs.

  • (2) The agencies in (1) of this subsection adopted the release form and its guidelines for use when agencies need information maintained by another of the participating agencies to provide services to a child and his or her family.

    • (A) The release does not allow information to be obtained from or released to a participating agency when the information is not otherwise subject to release by written consent.

    • (B) Confidential information maintained by OKDHS is only released in compliance with state and federal law and agency policy per OAC 340:75-1-42 through 340:75-1-45.  Signed Form 04MP001E does not require or further allow release of information except to the extent allowed by OKDHS policy.  In most circumstances, when OKDHS receives Form 04MP001E from a participating agency it is treated as a request for disclosure of relevant case information by an authorized service provider entitled to such information without a court order under one or more specific provisions per OAC 340:75-1-42 through 340:75-1-45.

    • (C) Form 04MP001E is not required for an otherwise authorized disclosure, nor does the form alone authorize any disclosure which would be unauthorized per OAC 340:75-1-42 through 340:75-1-45.

(b) When completing Form 04MP001E, note that state law allows for medical and/or mental health treatment, with certain exceptions, of some minors without parental consent as provided in Section 2602 of Title 63 of the Oklahoma Statues (63 O.S. § 2602).  When a minor is legally competent to consent to his or her own treatment, no other person, including a parent, may consent to the release of records relating to such treatment.  Minors who cannot consent for treatment cannot release treatment records.  Consent may only be given by the parent, guardian, or legal custodian.

(c) Appropriate authorizing persons may sign a release for the transfer of a copy of confidential records from one state agency to another.  The release is dated and notarized or bear the appropriate agency staff signature and is only valid for a period of one year.  Form 04MP001E is used in such situations.  The release is available for use only when release of the confidential information is not otherwise prohibited by state or federal law.  Rules and policy of each participating agency should be consulted to ascertain whether certain restrictions on transfer may apply to specific types of records maintained by various agencies.

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