Release Authorization

We understand that situations may arise that prevent you from being present to receive the participant at the time of drop off at the residence. The Release Authorization form is to authorize another person(s) (i.e. family member, neighbor, care giver, etc.) to receive the participant. Please fill in the information requested, sign the release, and click the “Submit” button on the form. Customer Service will receive the form and ensure that it is processed.

Please Note

  • Upon R&D’s receipt of this form, a phone call will be made to the home to confirm your authorization before the driver is notified to release the participant unattended.
  • The participant must have access to enter the residence and be able to enter the residence on their own.
  • No statements, other than the required information that is asked, can be written on the Release Authorization Form. Otherwise, the form cannot be processed and this Release Authorization form will not be valid.