Get Duke Hipaa Release Form

The Duke Hipaa Release Form is an important document that allows you to specify how your health information can be shared. This guide will help you fill out the form online with clear steps and instructions to ensure your preferences are accurately communicated.

Follow the steps to complete the Duke Hipaa Release Form online.

1. Press the ‘Get Form’ button to obtain the Duke Hipaa Release Form and open it in your preferred online editing tool.
2. Enter your name in the designated field for 'Patient Name'.
3. Fill in your date of birth in the corresponding field labeled 'Date of Birth'.
4. Provide your practice chart number in the space marked 'Practice Chart #.'
5. Insert your Duke MRN/History number in the field labeled 'Duke MRN/History #.'
6. Indicate your practice name, which should be 'Wake Forest Family Physicians,' if applicable.
7. Specify the alternative communication methods you prefer for receiving medical information by checking the appropriate boxes.
8. For each checked option, fill in the name and number or any specific details requested.
9. Review your entries for accuracy and completeness.
10. Save your changes and you can choose to download, print, or share the filled form as needed.

Complete your Duke Hipaa Release Form online today to ensure your health information is managed according to your preferences.