Social Security Administration

Fill out Form SSA-3288 online

Consent for Release of Information

Form SSA-3288 gives the Social Security Administration your written permission to release information or records about you to a person or organization you name, such as a doctor or an insurance company. A parent or legal guardian can also use it for a minor child's non-medical records, and a legal guardian can use it for a legally incompetent adult.

Fill out Form SSA-3288 Blank form from the SSA

The form opens in our PDF editor with its own fields ready to type into. You can fill it in without an account; downloading the filled PDF needs a free account. A free account gets 15 credits a day, enough for one form a day.

Edition: (04-2026)
Pages: 3
Fillable fields: 43
Checked against the SSA: November 8, 2026

GuruPDF is not affiliated with the Social Security Administration. This page explains the form in plain words; it is not legal or tax advice. Always check the official instructions before you file.

Who uses Form SSA-3288

People who want Social Security to send their records to a doctor, an insurance company or another person or group
Natural or adoptive parents and legal guardians acting for a minor child (non-medical records only)
Legal guardians acting for a legally incompetent adult
People asked to give written consent by someone who needs their Social Security claim file records

Before you start

Full name, date of birth and full Social Security number of the person the records are about
Name and address of the person or organization that should receive the records (their phone number is optional)
The reason you want the information released
The specific records you want released, with date ranges for benefit amounts, SSI payment amounts, Medicare entitlement or medical records
Proof of relationship if you are not the subject of the record
A pen, because the printed form must be signed by hand

How to fill out Form SSA-3288

Identify the subject of the record
At the top of page 2, enter the full name, date of birth (MM/DD/YYYY) and full Social Security number of the person whose records will be released. Fields marked with one asterisk (*) are required, and Social Security will not honor the form if any of them is blank.
Name who should receive the records
Enter the name and address of the person or organization Social Security should send the information to. The recipient's phone number is marked with two asterisks (**), which means it is not mandatory, but the form asks you to fill it in in case Social Security needs to contact you.
Give the reason for the release
In the box "I want this information released because", state the purpose, for example litigation, an investigation or determining eligibility for benefits. A parent or legal guardian acting for a minor child or a legally incompetent adult must also explain how the release is in that person's best interest. Social Security may charge a fee when the purpose is not related to its programs.
Choose the records in items 1 to 9
Check at least one box. Items 1 to 3 cover Social Security number verification and the current monthly Social Security benefit or Supplemental Security Income payment amount. Items 4 to 7 (Social Security benefit amounts, SSI payment amounts, Medicare entitlement and medical records) need a from date and a to date. Item 8 is complete medical records; do not check both 7 and 8. Item 9 is for other records, which you must name, such as award or denial notices, benefit applications or appeals.
Sign and date the declaration
Read the statement that you are the person the record is about, or the parent or legal guardian of a minor, or the legal guardian of a legally incompetent adult, and that the information is true and correct under penalty of perjury. The signature and date are required. Your address and daytime phone are marked as not mandatory. The Relationship line is for a signer who is not the subject of the record.
Add witnesses only if signing by mark (X)
Witnesses are needed only when the signature is a mark (X). In that case, print the signer's name next to the mark, and two witnesses who know the signer sign on lines 1 and 2 and give their full addresses (number and street, city, state and ZIP code). Social Security policy says the witnesses must be people who do not stand to gain anything from the disclosure.

After you fill it out

Print the form, sign it in ink, and send or bring it to the local Social Security office that serves the subject of the record. You can find that office with Social Security's office locator by entering the subject's ZIP code. Social Security's Privacy Act request page says you may hand deliver, mail or fax the signed paper consent to that office, and that a request for a copy of an original SS-5 or Numident goes to a different office with payment, so follow that page for those requests. Social Security sends the released information to the person or organization named on the form; check the official pages for any fee that may apply.

Signing: Social Security policy says the fillable SSA-3288 needs a handwritten (wet) signature: you may type in the boxes, but you must download, print and sign the form in ink before sending it. If the signer signs by mark (X), the two witnesses must also sign by hand.

Watch out for

Social Security will not honor the form if a required (*) field is blank, or if it asks for "any and all records" or "the entire file". You must name the records you want.
Do not use this form for a minor child's medical records or for detailed earnings or employment history. For earnings information, the form says to complete and mail Form SSA-7050-F4 instead.
Unless you state otherwise, the consent is good for one release only. It is valid for one year from the date you sign, or 90 days if it includes medical records, and Social Security policy says it must receive the form within that time.
Social Security strongly discourages sending consent forms or other documents with personal information by unsecured email.

Questions about Form SSA-3288

Can I sign Form SSA-3288 electronically?

No. Social Security accepts only a handwritten ink signature on a paper consent such as the SSA-3288. A separate online consent, Form SSA-3288-OP1, is completed and signed on Social Security's website after you verify your identity, but only by the record holder, who must be 18 or older, and only for certain record types.

How long does the consent stay valid?

The form says it is valid for one year from the date of signature, or 90 days if it includes a request for medical records. Unless you specify otherwise, it covers a one-time release.

Can a parent sign for a child?

A natural or adoptive parent or legal guardian can use the form to release a minor child's non-medical records and must explain how the release is in the child's best interest. Social Security requires proof of relationship when the signer is not the subject of the record. For a minor child's medical records, the form says to visit a local office or call Social Security instead.

Can I use it to have a copy of an original SS-5 or Numident record sent to someone else?

Yes. Social Security asks you to write "Numident" or "Original Form SS-5" in the other records item (item 9). These requests are not sent to the local office and must include payment, so follow the instructions on Social Security's Privacy Act request page.

Will Social Security accept an older edition of the form?

The current edition is printed with "Discontinue Prior Editions", but Social Security policy says staff should not refuse an earlier version of the SSA-3288 if it meets all of the consent requirements. A form that does not meet them is returned with an explanation.