I may revoke this authorization at any time by providing written notice of revocation. I acknowledge, however, that I may not revoke the authorization retroactively for information already released. This information is part of a confidential record which is protected by state law. State law prohibits further disclosure of this information without the specific written consent of the protected person, or legal representative, or otherwise permitted by law. TAC-Title 225 Part II-CH 403, subchapter K-403.295
"The use of scanned or facsimile signatures for the execution of this Release shall be legal and binding and shall have the same full force and effect as if originally signed."