Form HEA8019 Authorization to Release Information - Help Me Grow - Ohio

What Is Form HEA8019?

This is a legal form that was released by the Ohio Department of Health - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form HEA8019?
A: Form HEA8019 is the Authorization to Release Information for the Help Me Grow program in Ohio.

Q: What is the Help Me Grow program in Ohio?
A: Help Me Grow is a program in Ohio that provides early intervention services for infants and young children with developmental delays or disabilities.

Q: Why do I need to complete Form HEA8019?
A: You need to complete Form HEA8019 to give consent for the Help Me Grow program to share information with other agencies or individuals involved in your child's care.

Q: Who should complete Form HEA8019?
A: The parent or legal guardian of the child should complete Form HEA8019.

Q: What information do I need to provide on Form HEA8019?
A: You will need to provide your child's name, date of birth, and other identifying information, as well as your contact information and signature.

Q: How long does it take to process Form HEA8019?
A: The processing time for Form HEA8019 may vary depending on the Help Me Grow office. It is best to contact your local office for more information.

Q: Is there a fee for submitting Form HEA8019?
A: No, there is no fee for submitting Form HEA8019.

Q: Can I revoke the authorization on Form HEA8019?
A: Yes, you can revoke the authorization at any time by submitting a written notice to your local Help Me Grow office.