Instructions for Using this Form Complete this form only if you want us to give information or records about you, a minor, or a legally incompetent adult, to an individual or group (for …

There are four types of records: official records, transitory records, non-records, and personal records. Some records are kept for a short amount of time, and some records have long …

Instructions for the Use of the HIPAA-compliant Authorization Form to Release Health Information Needed for Litigation This form is the product of a collaborative process between the New …

These procedures will help DHS successfully accomplish its mission, preserve official records in accordance with applicable statutory and regulatory requirements, and promote access to …

This information is to be released for the purpose stated above and may not be used by recipient for any other purpose.

REQUEST / AUTHORIZATION FOR HEALTH INFORMATION (MEDICAL RECORDS) Please read carefully and complete the reverse side of this form. All sections of this authorization …

Instructions: This form is to be used by a patient or legal representative to authorize the release of information to a third party (other than a family member or friend) such as an insurance …