{"id":41753,"date":"2025-01-03T13:42:10","date_gmt":"2025-01-03T19:42:10","guid":{"rendered":"https:\/\/texascasa.org\/?post_type=resources&#038;p=41753"},"modified":"2026-02-09T09:25:45","modified_gmt":"2026-02-09T15:25:45","slug":"permission-to-release-health-information","status":"publish","type":"resources","link":"https:\/\/texascasa.org\/es\/program-portal\/resources\/permission-to-release-health-information\/","title":{"rendered":"Permission to Release Health Information (Template) + TMRPA Training"},"content":{"rendered":"\n<p>The Texas Medical Records Privacy Act (TMRPA) protects patients&#8217; personal health information (PHI) by guaranteeing that patients know how their PHI will be used and shared and prohibits organizations and providers from using or disclosing PHI without their consent. All patients also have the right to revoke permission to release and review their protected health information at any time. <\/p>\n\n\n\n<p>The template below complies with the requirements of the TMRPA and can be used when a CASA volunteer needs a parent or caregiver&#8217;s permission to access their protected health information from DFPS, Community-Based Care, service providers or others who may have protected health information relevant to the child&#8217;s best interest. Always provide a copy of the Permission to Release Health Information to the person granting the permission.<\/p>\n\n\n\n<p>Download the Printable, Customizable, or Form versions in English and Spanish below:<\/p>\n\n\n<style>.kb-row-layout-id41753_549c2a-1d > .kt-row-column-wrap{align-content:start;}:where(.kb-row-layout-id41753_549c2a-1d > .kt-row-column-wrap) > .wp-block-kadence-column{justify-content:start;}.kb-row-layout-id41753_549c2a-1d > .kt-row-column-wrap{column-gap:var(--global-kb-gap-md, 2rem);row-gap:var(--global-kb-gap-md, 2rem);padding-top:var(--global-kb-spacing-sm, 1.5rem);padding-bottom:var(--global-kb-spacing-sm, 1.5rem);}.kb-row-layout-id41753_549c2a-1d > .kt-row-column-wrap > div:not(.added-for-specificity){grid-column:initial;}.kb-row-layout-id41753_549c2a-1d > .kt-row-column-wrap{grid-template-columns:repeat(3, minmax(0, 1fr));}.kb-row-layout-id41753_549c2a-1d > .kt-row-layout-overlay{opacity:0.30;}@media all and (max-width: 1024px){.kb-row-layout-id41753_549c2a-1d > .kt-row-column-wrap > div:not(.added-for-specificity){grid-column:initial;}}@media all and (max-width: 1024px){.kb-row-layout-id41753_549c2a-1d > .kt-row-column-wrap{grid-template-columns:repeat(3, minmax(0, 1fr));}}@media all and (max-width: 767px){.kb-row-layout-id41753_549c2a-1d > .kt-row-column-wrap > div:not(.added-for-specificity){grid-column:initial;}.kb-row-layout-id41753_549c2a-1d > .kt-row-column-wrap{grid-template-columns:minmax(0, 1fr);}}<\/style><div class=\"kb-row-layout-wrap kb-row-layout-id41753_549c2a-1d alignnone wp-block-kadence-rowlayout\"><div class=\"kt-row-column-wrap kt-has-3-columns kt-row-layout-equal kt-tab-layout-inherit kt-mobile-layout-row kt-row-valign-top\">\n<style>.kadence-column41753_76da11-97 > .kt-inside-inner-col,.kadence-column41753_76da11-97 > .kt-inside-inner-col:before{border-top-left-radius:0px;border-top-right-radius:0px;border-bottom-right-radius:0px;border-bottom-left-radius:0px;}.kadence-column41753_76da11-97 > .kt-inside-inner-col{column-gap:var(--global-kb-gap-sm, 1rem);}.kadence-column41753_76da11-97 > .kt-inside-inner-col{flex-direction:column;}.kadence-column41753_76da11-97 > .kt-inside-inner-col > .aligncenter{width:100%;}.kadence-column41753_76da11-97 > .kt-inside-inner-col:before{opacity:0.3;}.kadence-column41753_76da11-97{position:relative;}@media all and (max-width: 1024px){.kadence-column41753_76da11-97 > .kt-inside-inner-col{flex-direction:column;justify-content:center;}}@media all and (max-width: 767px){.kadence-column41753_76da11-97 > .kt-inside-inner-col{flex-direction:column;justify-content:center;}}<\/style>\n<div class=\"wp-block-kadence-column kadence-column41753_76da11-97\"><div class=\"kt-inside-inner-col\">\n<h2 class=\"wp-block-heading\" id=\"document\">Document <\/h2>\n\n\n\n<p>Edit in Word to customize.<\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/texascasa.org\/wp-content\/uploads\/2025\/01\/Permission-to-Release-Information-01.02.2025_Eng-1.docx\">Document: English<\/a><\/div>\n\n\n\n<div class=\"wp-block-button is-style-outline is-style-outline--1\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/texascasa.org\/wp-content\/uploads\/2025\/01\/Permission-to-Release-Information-01.02.2025_ES.docx\">Document: Spanish<\/a><\/div>\n<\/div>\n<\/div><\/div>\n\n\n<style>.kadence-column41753_b96a7a-76 > .kt-inside-inner-col,.kadence-column41753_b96a7a-76 > .kt-inside-inner-col:before{border-top-left-radius:0px;border-top-right-radius:0px;border-bottom-right-radius:0px;border-bottom-left-radius:0px;}.kadence-column41753_b96a7a-76 > .kt-inside-inner-col{column-gap:var(--global-kb-gap-sm, 1rem);}.kadence-column41753_b96a7a-76 > .kt-inside-inner-col{flex-direction:column;}.kadence-column41753_b96a7a-76 > .kt-inside-inner-col > .aligncenter{width:100%;}.kadence-column41753_b96a7a-76 > .kt-inside-inner-col:before{opacity:0.3;}.kadence-column41753_b96a7a-76{position:relative;}@media all and (max-width: 1024px){.kadence-column41753_b96a7a-76 > .kt-inside-inner-col{flex-direction:column;justify-content:center;}}@media all and (max-width: 767px){.kadence-column41753_b96a7a-76 > .kt-inside-inner-col{flex-direction:column;justify-content:center;}}<\/style>\n<div class=\"wp-block-kadence-column kadence-column41753_b96a7a-76\"><div class=\"kt-inside-inner-col\">\n<h2 class=\"wp-block-heading\" id=\"pdf-version\">PDF Version<\/h2>\n\n\n\n<p>Download below to print. <\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/texascasa.org\/wp-content\/uploads\/2025\/01\/Printable-Permission-to-Release-Information-01.02.2025_Eng.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">PDF: English<\/a><\/div>\n\n\n\n<div class=\"wp-block-button is-style-outline is-style-outline--2\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/texascasa.org\/wp-content\/uploads\/2025\/01\/Printable-Permission-to-Release-Information-01.02.2025_ES-1.pdf\">PDF: Spanish<\/a><\/div>\n<\/div>\n<\/div><\/div>\n\n\n<style>.kadence-column41753_4437a1-e2 > .kt-inside-inner-col,.kadence-column41753_4437a1-e2 > .kt-inside-inner-col:before{border-top-left-radius:0px;border-top-right-radius:0px;border-bottom-right-radius:0px;border-bottom-left-radius:0px;}.kadence-column41753_4437a1-e2 > .kt-inside-inner-col{column-gap:var(--global-kb-gap-sm, 1rem);}.kadence-column41753_4437a1-e2 > .kt-inside-inner-col{flex-direction:column;}.kadence-column41753_4437a1-e2 > .kt-inside-inner-col > .aligncenter{width:100%;}.kadence-column41753_4437a1-e2 > .kt-inside-inner-col:before{opacity:0.3;}.kadence-column41753_4437a1-e2{position:relative;}@media all and (max-width: 1024px){.kadence-column41753_4437a1-e2 > .kt-inside-inner-col{flex-direction:column;justify-content:center;}}@media all and (max-width: 767px){.kadence-column41753_4437a1-e2 > .kt-inside-inner-col{flex-direction:column;justify-content:center;}}<\/style>\n<div class=\"wp-block-kadence-column kadence-column41753_4437a1-e2\"><div class=\"kt-inside-inner-col\">\n<h2 class=\"wp-block-heading\" id=\"digital-form\">Digital Form<\/h2>\n\n\n\n<p>Allow for fillable sections.<\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/texascasa.org\/wp-content\/uploads\/2025\/01\/Fillable-Permission-to-Release-Information-01.02.2025_Eng.docx\">Form: English<\/a><\/div>\n\n\n\n<div class=\"wp-block-button is-style-outline is-style-outline--3\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/texascasa.org\/wp-content\/uploads\/2025\/01\/Fillable-Permission-to-Release-Information-01.02.2025_ES.docx\">Form: Spanish<\/a><\/div>\n<\/div>\n<\/div><\/div>\n\n<\/div><\/div>\n\n<style>.wp-block-kadence-advancedheading.kt-adv-heading41753_7d8600-3b, .wp-block-kadence-advancedheading.kt-adv-heading41753_7d8600-3b[data-kb-block=\"kb-adv-heading41753_7d8600-3b\"]{padding-top:var(--global-kb-spacing-md, 2rem);font-style:normal;}.wp-block-kadence-advancedheading.kt-adv-heading41753_7d8600-3b mark.kt-highlight, .wp-block-kadence-advancedheading.kt-adv-heading41753_7d8600-3b[data-kb-block=\"kb-adv-heading41753_7d8600-3b\"] mark.kt-highlight{font-style:normal;color:#f76a0c;-webkit-box-decoration-break:clone;box-decoration-break:clone;padding-top:0px;padding-right:0px;padding-bottom:0px;padding-left:0px;}.wp-block-kadence-advancedheading.kt-adv-heading41753_7d8600-3b img.kb-inline-image, .wp-block-kadence-advancedheading.kt-adv-heading41753_7d8600-3b[data-kb-block=\"kb-adv-heading41753_7d8600-3b\"] img.kb-inline-image{width:150px;vertical-align:baseline;}<\/style>\n<h2 id=\"tmrpa-training\" class=\"kt-adv-heading41753_7d8600-3b wp-block-kadence-advancedheading\" data-kb-block=\"kb-adv-heading41753_7d8600-3b\">TMRPA Training with Andi March<\/h2>\n\n\n\n<p>If you missed the virtual training with <strong>Andi March<\/strong>&nbsp;on the&nbsp;<strong>Texas Medical Records Privacy Act<\/strong>&nbsp;you can watch the recording below.<\/p>\n\n\n<style>.wp-block-kadence-advancedbtn.kb-btns41753_200107-5f{gap:var(--global-kb-gap-xs, 0.5rem );justify-content:center;align-items:center;}.kt-btns41753_200107-5f .kt-button{font-weight:normal;font-style:normal;}.kt-btns41753_200107-5f .kt-btn-wrap-0{margin-right:5px;}.wp-block-kadence-advancedbtn.kt-btns41753_200107-5f .kt-btn-wrap-0 .kt-button{color:#555555;border-color:#555555;}.wp-block-kadence-advancedbtn.kt-btns41753_200107-5f .kt-btn-wrap-0 .kt-button:hover, .wp-block-kadence-advancedbtn.kt-btns41753_200107-5f .kt-btn-wrap-0 .kt-button:focus{color:#ffffff;border-color:#444444;}.wp-block-kadence-advancedbtn.kt-btns41753_200107-5f .kt-btn-wrap-0 .kt-button::before{display:none;}.wp-block-kadence-advancedbtn.kt-btns41753_200107-5f .kt-btn-wrap-0 .kt-button:hover, .wp-block-kadence-advancedbtn.kt-btns41753_200107-5f .kt-btn-wrap-0 .kt-button:focus{background:#444444;}<\/style>\n<div class=\"wp-block-kadence-advancedbtn kb-buttons-wrap kb-btns41753_200107-5f\"><style>ul.menu .wp-block-kadence-advancedbtn .kb-btn41753_bc2397-ac.kb-button{width:initial;}.wp-block-kadence-advancedbtn .kb-btn41753_bc2397-ac.kb-button{color:var(--theme-palette-color-9, #fff);background:var(--theme-palette-color-3, #002857);font-size:var(--global-kb-font-size-md, 1.25rem);font-family:ct_font_geometric__black;text-transform:uppercase;border-top-left-radius:40px;border-top-right-radius:40px;border-bottom-right-radius:40px;border-bottom-left-radius:40px;padding-top:var(--global-kb-spacing-xs, 1rem);padding-right:var(--global-kb-spacing-lg, 3rem);padding-bottom:var(--global-kb-spacing-xs, 1rem);padding-left:var(--global-kb-spacing-lg, 3rem);margin-top:var(--global-kb-spacing-xxs, 0.5rem);margin-bottom:var(--global-kb-spacing-lg, 3rem);}.wp-block-kadence-advancedbtn .kb-btn41753_bc2397-ac.kb-button:hover, .wp-block-kadence-advancedbtn .kb-btn41753_bc2397-ac.kb-button:focus{color:var(--theme-palette-color-8, #ffffff);background:var(--theme-palette-color-2, #ed1b2e);border-top-left-radius:40px;border-top-right-radius:40px;border-bottom-right-radius:40px;border-bottom-left-radius:40px;}<\/style><a class=\"kb-button kt-button button kb-btn41753_bc2397-ac kt-btn-size-standard kt-btn-width-type-auto kb-btn-global-fill  kt-btn-has-text-true kt-btn-has-svg-false  wp-block-kadence-singlebtn\" href=\"https:\/\/www.dropbox.com\/scl\/fi\/qa743woz7v4thhlbzieqg\/March-2025-Medical-Records-with-Andi.mp4?rlkey=2vv4u03t5cse71233zolu12xt&#038;st=eqld9pyr&#038;dl=0\" target=\"_blank\" rel=\"noopener\"><span class=\"kt-btn-inner-text\">watch recording<\/span><\/a><\/div>\n\n\n\n<p>Access the TMRPA training slides in the link below. <\/p>\n\n\n<style>.wp-block-kadence-advancedbtn.kb-btns41753_303209-b8{gap:var(--global-kb-gap-xs, 0.5rem );justify-content:center;align-items:center;}.kt-btns41753_303209-b8 .kt-button{font-weight:normal;font-style:normal;}.kt-btns41753_303209-b8 .kt-btn-wrap-0{margin-right:5px;}.wp-block-kadence-advancedbtn.kt-btns41753_303209-b8 .kt-btn-wrap-0 .kt-button{color:#555555;border-color:#555555;}.wp-block-kadence-advancedbtn.kt-btns41753_303209-b8 .kt-btn-wrap-0 .kt-button:hover, .wp-block-kadence-advancedbtn.kt-btns41753_303209-b8 .kt-btn-wrap-0 .kt-button:focus{color:#ffffff;border-color:#444444;}.wp-block-kadence-advancedbtn.kt-btns41753_303209-b8 .kt-btn-wrap-0 .kt-button::before{display:none;}.wp-block-kadence-advancedbtn.kt-btns41753_303209-b8 .kt-btn-wrap-0 .kt-button:hover, .wp-block-kadence-advancedbtn.kt-btns41753_303209-b8 .kt-btn-wrap-0 .kt-button:focus{background:#444444;}<\/style>\n<div class=\"wp-block-kadence-advancedbtn kb-buttons-wrap kb-btns41753_303209-b8\"><style>ul.menu .wp-block-kadence-advancedbtn .kb-btn41753_9b14bd-96.kb-button{width:initial;}.wp-block-kadence-advancedbtn .kb-btn41753_9b14bd-96.kb-button{color:var(--theme-palette-color-9, #fff);background:var(--theme-palette-color-3, #002857);font-size:var(--global-kb-font-size-md, 1.25rem);font-family:ct_font_geometric__black;text-transform:uppercase;border-top-left-radius:40px;border-top-right-radius:40px;border-bottom-right-radius:40px;border-bottom-left-radius:40px;padding-top:var(--global-kb-spacing-xs, 1rem);padding-right:var(--global-kb-spacing-lg, 3rem);padding-bottom:var(--global-kb-spacing-xs, 1rem);padding-left:var(--global-kb-spacing-lg, 3rem);margin-top:var(--global-kb-spacing-xxs, 0.5rem);margin-bottom:var(--global-kb-spacing-lg, 3rem);}.wp-block-kadence-advancedbtn .kb-btn41753_9b14bd-96.kb-button:hover, .wp-block-kadence-advancedbtn .kb-btn41753_9b14bd-96.kb-button:focus{color:var(--theme-palette-color-8, #ffffff);background:var(--theme-palette-color-2, #ed1b2e);border-top-left-radius:40px;border-top-right-radius:40px;border-bottom-right-radius:40px;border-bottom-left-radius:40px;}<\/style><a class=\"kb-button kt-button button kb-btn41753_9b14bd-96 kt-btn-size-standard kt-btn-width-type-auto kb-btn-global-fill  kt-btn-has-text-true kt-btn-has-svg-false  wp-block-kadence-singlebtn\" href=\"https:\/\/www.dropbox.com\/scl\/fi\/il5odmyaw232kbia61pal\/CASA-Protected-Health-Information-TMPRA.pdf?rlkey=voo9ojzujg3wgf9n7rj2clqt3&#038;st=v2xzmhpy&#038;dl=0\" target=\"_blank\" rel=\"noopener\"><span class=\"kt-btn-inner-text\">access slides<\/span><\/a><\/div>\n","protected":false},"excerpt":{"rendered":"<p>The Texas Medical Records Privacy Act (TMRPA) protects patients&#8217; personal health information (PHI) by guaranteeing that patients know how their PHI will be used and shared and prohibits organizations and [&hellip;]<\/p>\n","protected":false},"featured_media":41779,"parent":0,"menu_order":0,"template":"","meta":{"_acf_changed":false,"_tec_requires_first_save":true,"_gspb_post_css":"","inline_featured_image":false,"_kad_blocks_custom_css":"","_kad_blocks_head_custom_js":"","_kad_blocks_body_custom_js":"","_kad_blocks_footer_custom_js":"","_EventAllDay":false,"_EventTimezone":"","_EventStartDate":"","_EventEndDate":"","_EventStartDateUTC":"","_EventEndDateUTC":"","_EventShowMap":false,"_EventShowMapLink":false,"_EventURL":"","_EventCost":"","_EventCostDescription":"","_EventCurrencySymbol":"","_EventCurrencyCode":"","_EventCurrencyPosition":"","_EventDateTimeSeparator":"","_EventTimeRangeSeparator":"","_EventOrganizerID":[],"_EventVenueID":[],"_OrganizerEmail":"","_OrganizerPhone":"","_OrganizerWebsite":"","_VenueAddress":"","_VenueCity":"","_VenueCountry":"","_VenueProvince":"","_VenueState":"","_VenueZip":"","_VenuePhone":"","_VenueURL":"","_VenueStateProvince":"","_VenueLat":"","_VenueLng":"","_VenueShowMap":false,"_VenueShowMapLink":false,"_tribe_blocks_recurrence_rules":"","_tribe_blocks_recurrence_description":"","_tribe_blocks_recurrence_exclusions":"","footnotes":""},"audience":[138,183],"resource_type":[141,169,134,135],"topics":[128,172],"class_list":["post-41753","resources","type-resources","status-publish","has-post-thumbnail","hentry","audience-program-staff","audience-volunteers","resource_type-handout","resource_type-template","resource_type-training","resource_type-video","topics-program-leadership-administration","topics-star"],"blocksy_meta":[],"acf":[],"taxonomy_info":{"audience":[{"value":138,"label":"Program 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