Release of Information Form

The Release of Information (ROI) form allows patients to consent to sharing their information with third parties. Before signing, patients can specify what information will be shared and the reason for the disclosure. Once the form is submitted, your practice will be prompted to review and sign it.

Enabling the Release of Information Form in Practice Library

Role Required: Practice Admin

Practice Admin can enable the Release of Information Form in the practice library under Portal Forms.

Note: The Release of Information form can be made "always available" so the patient can complete it at any time without needing to send a document request. Remember that the patient must select from one of their existing contacts already on file.

Navigate to Library > Portal Form > Release of Information to make this form always available on the portal.

Customizing the Release of Information Form

Role Required: Practice Admin

ROI can be customized to meet requirements set forth by your state or other governing credentialing entities. A standard Release of Information form, designed to comply with HIPAA requirements, has been provided to get you started in the Portal Library.

Navigate Library > Portal Form > Release of Information

To customize the Release of Information Form, select the edit icon in the upper right of the form.

You can customize the Types of Information to be shared and the Purpose of Disclosure, adjust the display order, and select which details are included.

Use the show toggles to choose items or the remove button to exclude any information you don’t want on the form.

You can customize the content for the Duration and Revocation of Authorization, Authorization, and Practice Acknowledgement sections in the text boxes.

Note: By selecting Set to Default, the content will revert to the standard Release of Information form TherapyNotes provided in the Library.

Sharing the Release of Information Form to the Client Portal

Role Required: Clinician, Biller, Practice Scheduler

The Release of Information (ROI) can be sent to the patient for one or more of their contacts, to be completed on the portal.

There are a couple ways to share the form on the Client portal.

Navigate Library > Portal Form > Release of Information > Scroll to the bottom “Share on Portal.”

Navigate to Patient Name > Portal > Share Documents > Release of Information Form > Select Contact > Send Document Request.

Note: The practice must merge the Patient Contacts Form into the client’s record before the patient can complete the Release of Information for new contacts.

Completing the Release of Information form in TherapyPortal

The Release of Information will appear under Documents > Paperwork & Forms> Release of Information. Select Sign to begin the process.

Complete and sign the form.

The patient needs to choose at least one option under “Types of Information to Share” and for the "Purpose of Disclosure".
If “Other” is selected, the patient must specify the the patient must specify the “Types of Information to Share” and “Purpose of Disclosure”.
Depending on the Type, the form will automatically select the relevant “Types of Information to Share” and for “Purpose of Disclosure”.

At the bottom of the form, click Submit Completed Document.

Viewing Release of Information Progress

Role Required: Clinician, Biller, Scheduler

The progress of the patient’s Release of Information form will be shown with the Document Requests or the Documents tab.

If the form has not been completed, a “Pending Patient Submission” status will be displayed.

If the patient has completed the form, a status of “Needs Processing: Signed” will be displayed.

Once the practice processes the form, a status of “Acknowledged by Practice” will be displayed.

Note: The practice must acknowledge the Release of Information form by signing the authorization.