Release of Information

This form of consent is used for housing and homeless services, which permits sharing of a client's personal and individual information (PII) with other service providers who aid clients. It is mandatory for any usage or disclosure that is not included in the agency's privacy notice. Certain organizations may mandate the collection of this form from all clients.

Alameda County Release of Information - English

Alameda County Release of Information - Arabic 

Alameda County Release of Information - Chinese 

Alameda County Release of Information - Dari

Alameda County Release of Information - Spanish 

Alameda County Release of Information - Tagalog 

Alameda County Release of Information - Russian 

Alameda County Release of Information - Khmer 

Alameda County Release of Information - Farsi

Alameda County Release of Information- Vietnamese

Clients sign this form to revoke their consent to share data outside of the HMIS-covered network. Any changes will take effect as of the date the form is signed, and any data or information shared before that time cannot be recalled.

Revocation Release of Information (ROI) - English 

Revocation Release of Information (ROI)  - Arabic 

Revocation Release of Information (ROI) - Chinese 

Revocation Release of Information (ROI)  - Dari

Revocation Release of Information (ROI) - Spanish 

Revocation Release of Information (ROI) - Tagalog 

Revocation Release of Information (ROI) - Russian 

Revocation Release of Information (ROI)  - Khmer 

Revocation Release of Information (ROI)  - Farsi

Revocation Release of Information (ROI) - Vietnamese

ACHMIS Participating Organizations - ROI

Please see the Participating Organizations within Alameda County HMIS. All or some of the projects in these agencies participate in the Alameda County HMIS.