Wheeling Jesuit University


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Phone: 1-304-243-8152

Counseling: Authorization of Release of Information

Date approved:
August 2013
Approved by:
Director of Human Resources
Date to be reviewed:
August 2014
Reviewed by:
Compliance Coordinator/Team
Date revised:
August 2013
Revision number:
Compliance Committee:
As Scheduled


To ensure confidentiality of professional services rendered


2.1 Authorization of Release of Information

Releases of information will be utilized to ensure informed consent of dissemination of any personal health information of the students.

2.2 Procedures

Authorization of Release of Information will be required by the client in order for the WJU Student COunseling service to Release their records to others. No third party records, records provided elsewhere that have been acquired will be released 


The Director of Human Resources has the authority to change, modify or approve exceptions to this policy at any time with or without notice and with the approval of the University President.


Sample Template of Authorization of Information Release

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