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The medical record information release (HIPAA) form allows patients to give authorization to a 3rd party and access their health records. It also allows the added option for healthcare providers to share information. Powers granted under a medical release can be revoked or reassigned at any time. Medical Records Release Authorization Form (Waiver) | HIPAA eforms.com ? release ? medical-hipaa eforms.com ? release ? medical-hipaa

A specific description of the information to be used or disclosed, including the dates of service. The purpose of the requested use and disclosure. The expiration date or event. The patient signature and date. Consent to Release Information - Penn State Altoona psu.edu ? confidentiality-privacy ? consen... psu.edu ? confidentiality-privacy ? consen...

I hereby authorize use or disclosure of protected health information about me as described below. I understand that the information used or disclosed may be subject to re-disclosure by the person or class of persons or facility receiving it, and would then no longer be protected by federal privacy regulations.

compliant HIPAA release form must, at the very least, contain the following information: A description of the information that will be used/disclosed. The purpose for which the information will be disclosed. The name of the person or entity to whom the information will be disclosed. HIPAA Release Form hipaajournal.com ? hipaareleaseform hipaajournal.com ? hipaareleaseform