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HIPAA Authorization Form

HIPAA-compliant authorization for release of protected health information

What's included

Legally sound document structure

Clear definitions and terms

Proper signature fields

Audit trail and timestamp

How it works

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2

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4

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Frequently Asked Questions

What is a HIPAA authorization form?

A HIPAA authorization form is a document required under the Health Insurance Portability and Accountability Act (HIPAA) that allows a healthcare provider to release your protected health information (PHI) to a specified person or organization.

What must a valid HIPAA authorization include?

Under 45 CFR § 164.508, a valid HIPAA authorization must include: a description of the information to be disclosed, who may disclose it, who may receive it, the purpose, an expiration date, the right to revoke, and the individual's signature.

Can a HIPAA authorization be signed electronically?

Yes, HIPAA permits electronic signatures on authorization forms, provided the signature method complies with the ESIGN Act. CanUSign provides a legally compliant electronic signature with a full audit trail.

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