General Hipaa Release Form For College Students

State:
Multi-State
Control #:
US-00993BG
Format:
Word; 
Rich Text
Instant download

Description

The General HIPAA Release Form for college students is designed to allow individuals to authorize the disclosure of their protected health information in compliance with the Health Insurance Portability and Accountability Act (HIPAA). This form is particularly useful for students who may need to share medical information with school health services or insurance providers. Key features include sections for the student to provide their personal information, the details of the entities involved in the release, and specific information that is authorized for disclosure. To fill out the form, students should clearly list their name, the name of the healthcare provider, and specify what information can be released. It is essential to sign and date the form, and it may need to be notarized depending on the institution's requirements. This form can also serve situations such as applying for health insurance, seeking medical treatment at campus facilities, or during academic program applications that require health evaluations. Attorneys, partners, owners, associates, paralegals, and legal assistants will find this form imperative for guiding students in complying with HIPAA regulations while facilitating necessary communications regarding health-related matters.
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FAQ

I hereby authorize use or disclosure of protected health information about me as described below. I understand that the information used or disclosed may be subject to re-disclosure by the person or class of persons or facility receiving it, and would then no longer be protected by federal privacy regulations.

These core elements include: The specific information that will be used or disclosed. The specific identifiers of the individuals(s) authorized to make the requested use or disclosure. The specific identification of any third parties who the covered entity may make the requested disclosure.

compliant HIPAA release form must, at the very least, contain the following information: A description of the information that will be used/disclosed. The purpose for which the information will be disclosed. The name of the person or entity to whom the information will be disclosed.

The Health Information Portability and Accountability Act of 1996 protects sensitive patient information. Once a student turns 18, much like FERPA, HIPAA gives them control over their health care and records.

HIPAA does not apply to student medical/counseling records at the college or university the student attends; FERPA does.

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General Hipaa Release Form For College Students