HIPPA requires no matter who has the information that they not release it with out a recent (within the past 6 months) release of information paper signed and dated. I know this because a therapy letter came into a dHS caseworkers hands. She chose to photocopy and distribute it without an active signed release of information form and the result was she lost her job and lost her state social workers license and can no longer work DHS cases in this state and most likely the US because the state license board here also reports such cases on the national level too. Right now that caseworker is living in another state (which also falls under the Civil Rights department jurisdiction that did the investigation in this state) under another last name instead of DHS she has opened her own private adoption agency working with those that want to adopt angle instead of taking and putting kids up for adoption.