CIE Authorization Forms – 211 San Diego

CIE Authorization Forms

  • What is an Authorization?

A CIE authorization is a legal document that allows information to be shared across health and social services within the CIE network for the purpose of care coordination. A signed CIE authorization represents a person’s informed consent to share their information with the CIE Partner Network.  

  • Value

When a person opts-into CIE, service providers working with this person are able to access key information to coordinate care, intervene during critical situations and provide responsive interventions.

  • Electronic Client Consent
  • Telephonic Client Consent
  • Download Paper Client Consent Form ( 6 languages)
  • Example of Authorization Use

At intake or enrollment into a program, having the individual sign if patient meets risk criteria

  • FAQ's and Best Practices
  • Verbal Consents (6 Languages)

To meet the needs of our shared clients/patients during the COVID19 pandemic, partners may temporarily capture consent verbally. Partners should upload a copy of this form in lieu of a signed document or recording.