Medical Information Release

Main Content

Morris Library

Form Title: Medical Information Release

Description: Form to be signed by employee to authorize the release of information to the Student Health Center.

Usage Notes: An employee signs this form to release medical information to the Student Health Center on behalf of Human Resources to determine eligibility and duration of Family and Medical Leave or Extended Sick Leave.

Use Documentation: None available

To be used by: Campus Use

Posted on: 24 Mar 2008

Posting by: Human Resources

Author: Clay Cochran

Author's email: claytonc@siu.edu

Form ID: hro1060