Authorization to Release Medical Records

Policy

In accordance with the HIPAA Privacy Rule, when protected health information is to be used or disclosed for purposes other than treatment, payment, or health care operations, the District will use and disclose it only pursuant to a valid, written authorization, unless such use or disclosure is otherwise permitted or required by law.

Procedure

  1. The District will obtain signed authorization from all individuals before using or disclosing their protected health information for purposes other than treatment, payment or health care operations, or otherwise required by law.
  2. The authorization form must be fully completed, signed and dated by the patient or patient’s personal representative before the PHI is used or disclosed.

Download: Authorization to Release Medical Records [PDF]

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