Virgin Islands Authorization for Release of Personal Information
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How to fill out Authorization For Release Of Personal Information?
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FAQ
This form is used to release your protected health information as required by federal and state privacy laws. Your authorization allows the Health Plan (your health insurance carrier or HMO) to release your protected health information to a person or organization that you choose.
Walk-in Service is available between A.M. and P.M. at the following locations: Virgin Islands Department of Health John Moorehead Complex, Hospital Ground (located directly behind Lionel Roberts Stadium) St. Thomas, VI Tel#: (340) 774-9000 ext. 4685.
Birth and death records for St. Croix may be obtained from Registrar of Vital Statistics, Charles Harwood Memorial Hospital, Christiansted, St. Croix, VI 00820. Divorce records may be obtained from the Deputy Clerk of District Court and marriage records from the Judge of Police Court, Christiansted, St Croix, VI 00820.
Release of information (ROI) is the process of providing access to protected health information (PHI) to an individual or entity authorized to receive or review it.
No. The HIPAA Privacy Rule permits a health care provider to disclose protected health information about an individual, without the individual's authorization, to another health care provider for that provider's treatment of the individual.
In-Person RequestsVisit the St Croix County Register of Deeds Office during their office hours.Complete the appropriate vital record application form.Present valid Driver's License or other identification as listed on the back of application form.More items...
Generally, an authorization provides the authority for a doctor's release of PHI for specified purposes, which are generally other than treatment, payment, or healthcare operations, or, to disclose protected health information to a third party specified by the individual.
Vital Records and Statistics Locations and Contact Information:St. Croix: Charles Harwood Complex. Phone: (340) 718-1311. Extensions: 3688, 3846, and 3686.St. Thomas: Dr. John S. Moorehead Municipal Hospital Complex. Phone: (340) 774-9000. Extensions: 4685, 4686, 4683, and 4681.
Applications for birth certificates may be obtained at the Clerk's Office, 2nd floor, City Hall, 545 Talbot Street, St. Thomas or downloaded from the Ministry's website.
The core elements of a valid authorization include:A meaningful description of the information to be disclosed.The name of the individual or the name of the person authorized to make the requested disclosure.The name or other identification of the recipient of the information.More items...
