What is Form SSA-3288?
Form SSA-3288 stands for the ‘Social Security Administration Consent for Release of Information.’ This is basically a document which provides the official and written consent for groups and players who might be in need for specific pieces of information which might assist in securing the necessary financial assistance for a needy person.
Why is it used?
The form is used to extract those pieces of information which might assist in assessing the sincerity and levels of need of the affected persons. Some of the persons and entities who might find it useful are the insurance companies, doctors, and caregivers, to mention but a few!
How to fill Form SSA-3288 (Step-by-step Guide)
Step I: Download the form
Needless to point out, you have to first and foremost download the form from the official government portal. Follow this link to access the form online or download it from here:
Beware of potential scammers. There are various sites that masquerade as legitimate government sites. They will usually extort money from you and steal your identity from the information you give.
Upon downloading the form, you are required to review all the terms that are stipulated on the form. In case there are any issues which might be ambiguous, you are required to seek further clarification.
Should you find the document too complicated, you are advised to seek external assistance typically from the nearest social security office or agent.
Step II: Fill out your basic details
You now have to fill out your basic details. You will find these on the second page of the form. The details mainly encompass the following areas:
- Your full name
- Date of birth in the mm//dd/yyyy format
- Social security number
Step III: Sanction the release of your records and documents
Flip over to the next page. Here, you will sanction the release of your records and documents. To do this, you have to furnish the organizations and persons who are to be allowed to access those records. Then, you will state the reasons which this information has to be released. These you do in the lines provided for.
Step IV: Specify the precise piece of information you would wish released.
Turn over to the next page. You will now specify the precise piece of information you would wish released. Choose from the list below:
- Social Security Number
- Present social security benefit amounts
- Present supplemental security income monthly payment amount
- Benefit amounts
- Medicare entitlement
- Medical Records from claims folder(s)
- Complete medical records from claim folder(s)
- Other records from files (clarify in the lines provided)
Step V: Append your signature
Conclude the exercise by appending your signature. You are advised to read the agreement fully and then accept the terms of references. This is to let you make informed decisions thereafter. Lastly, furnish the following pieces of information:
- Your signature as a caregiver or self
- Date of signature
- Complete address
- Your relation with the applicant
- Daytime telephone number
- Signature of the witnesses
- The physical address of the witnesses (inclusive of the zip code)
NB: The witness only signs if the applicant’s signature is missing, bears an ‘X’ sign or any other dedicated mark.