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  • Hipaa Release Form - Saltzer Medical Group

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SALTZER CLINICS AUTHORIZATION OF USE OR DISCLOSURE OF PROTECTED HEALTH INFORMATION 215 E. Hawaii Ave. 9850 W. St. Lukes Dr. Nampa, ID 83686 Nampa, ID 83687 (208) 4633229 (208) 4633229 Fax: 208 4654825.

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Saltzer, which was acquired by Intermountain in October 2020, is actively negotiating purchase of its operations with healthcare companies and is "optimistic" that a sale of the physician group can be achieved.

Tommy Ahlquist, a prominent Idaho developer and former emergency room physician, bought Saltzer in early 2019 before selling it to Intermountain.

Saltzer Health announced last January that it was closing services on March 29, due to ongoing financial and economic pressures and challenges that it and other health institutions nationwide were facing.

A HIPAA release form is a document that – when signed – allows healthcare providers to share a patient's protected health information (PHI) with specified individuals or organizations, ing to the details stipulated in the form.

Intermountain Health — which runs 33 hospitals and 385 clinics across seven states, ing to its website —had acquired the group practice in 2020. Idaho Statesman noted that the large nonprofit scrubbed nearly all logos and other mentions of its branding from Saltzer Health's website upon the release of the news.

How do I fill out a HIPAA release form? Provide instructions. ... Name the patient and individual authorized to use or disclose their PHI. ... Describe the information. ... Specify recipients. ... Specify the purpose of disclosure. ... Specify the time period. ... Detail their revocation rights. ... Obtain the patient's signature.

If a patient wants to give a family member or another third-party access to private health information, the HIPAA Authorization Form For Family Members must be filled out and signed by both parties. This form must be completed to disclose protected health information to a third party, including family members.

"Saltzer Health has more than 400 employees and serves just under 80,000 patients annually.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232