Procedure Name:	Release of Personal information
Scope:	All Employees
Revision Date:	August 28, 2020
Last Review Date:	June 9, 2023

Reliant does not release personal information about its employees to third parties unless there is consent from the employee. Third-Party Designees may include parents, spouses, children, and others.

You may grant Reliant permission to release certain information to a third party by submitting this form for each party authorized to receive or access your personal information.

Further, Reliant must have contact information on file for someone to call in case of an emergency. Please use this form to update your emergency contact and indicate what information we can discuss with that individual.

Complete the form below.

If you do not see the form below, make sure you are logged in to your reliant.org Google Account on this browser. You can do this at mail.reliant.org or drive.reliant.org. Refresh this page after you sign in.
If you are on a mobile device or using Internet Explorer and have trouble reading the form, you can use this alternate link.

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