Get Compound Authorization - Wakemed
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How to fill out the COMPOUND AUTHORIZATION - Wakemed online
This guide provides comprehensive instructions on how to complete the COMPOUND AUTHORIZATION form for WakeMed. It is designed to assist users in effectively filling out the form while ensuring clarity and understanding of each section.
Follow the steps to complete the form accurately
- Click the ‘Get Form’ button to access the COMPOUND AUTHORIZATION and open it in the respective online editor.
- In the first section, specify whether you choose to designate other persons or entities to receive your health information. Indicate your choice clearly.
- Provide permission for WakeMed Faculty Physicians to release your health information. Fill in the entities' names and select the types of information to be shared, such as financial/billing and medical information.
- For each individual you wish to designate, including a spouse or significant other, parent, family member, and employer, provide their name and specify the information to be shared.
- Review the rights of the patient outlined in the form, which include your rights regarding the information to be disclosed and your ability to revoke this authorization.
- Sign and date the form in the patient/representative signature section. If applicable, a witness should also sign.
- For individuals unable to sign, complete the relevant section and ensure a witness signs as well.
- Once all necessary fields are completed, save your changes to the form. You can then download, print, or share the completed authorization.
Complete your COMPOUND AUTHORIZATION online today for efficient management of your health information.
A compound HIPAA authorization allows for the sharing of health information for more than one purpose, such as treatment and research, within a single signed document. This type of authorization ensures that patients understand and agree to multiple uses of their information simultaneously. Using a well-crafted compound authorization at WakeMed can improve service delivery while maintaining compliance with legal requirements.
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