This document is a HIPAA-compliant authorization form that allows a patient to authorize the release of their health information for litigation purposes. It provides information about what types of health information may be disclosed, such as alcohol/drug treatment, mental health, and HIV status if the patient initials the corresponding boxes. The patient can authorize a specific provider or entity to disclose their medical records for a certain date range and/or types of information. The recipient of the information and the purpose/reason for disclosure are also specified. The patient signature authorizes the disclosure of the health information pursuant to HIPAA and provides instructions on revoking the authorization.