Information Sharing Authorization

The Information Sharing Authorization (ISA) is an electronic and paper form that accompanies and supports the use of the Community Health Record (CHR), now known as AC Care Connect, and Social Health Information Exchange (SHIE). The ISA is a tool that helps improve care coordination and health outcomes for consumers.

The form allows consumers to consent to sharing of their medical and mental health, housing, social services and jail health information with and between the SHIE/CHR partner organizations working with that consumer, as allowed by Federal and State regulations.

For detailed instructions on how to upload an Information Sharing Authorization to the Community Health Record, please refer to the Tip Sheet on Uploading ISAs in Elemeno

English ISA

Spanish ISA

Arabic ISA

Chinese ISA


Punjabi ISA

Tagalog ISA

Vietnamese ISA