Modèle gratuit

HIPAA Authorization Form

HIPAA-compliant authorization for release of protected health information

Ce qui est inclus

Structure documentaire juridiquement solide

Définitions et termes clairs

Champs de signature appropriés

Piste d'audit et horodatage

Comment ça marche

1

Choisir le modèle

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2

Remplir les détails

Entrez toutes les informations requises

3

Partager le lien

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4

Obtenir les signatures

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Questions frequentes

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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