The release of information document must include the following:(1) name of no more than one person or organization to which the information is being released;(2) specific information to be released;(3) beginning and ending dates the release is effective, not to exceed the resident's stay or the nonresident's active length of services;(4) date and the signatures of the resident or nonresident and the employee or volunteer; and(5) right to revoke a release of information at any time. This revocation request must be submitted in writing.