Purpose. To obtain an individual's authorization to release medical information to: the Texas Health and Human Services Commission (HHSC). To fill out this form and submit via mail or fax, please download the Authorization to Disclose Health Information Form (PDF).Form 6700, Use and Release of Health Information Authorization. Instructions for Opening a Form. How to fill out the Texas Health Services Permission Form 2870? (iii) Special Information: This authorization may include disclosure of information relating to DRUG, ALCOHOL and. Authorization for Disclosure of Health Information. Release of my records will be for the purpose stated on this form.