Get Osu Shs Authorization For Release Of Health Information 2020-2025

Completing the OSU SHS Authorization For Release Of Health Information form online is a straightforward process. This guide will provide you with step-by-step instructions to ensure you fill out the form correctly and efficiently.

Follow the steps to successfully complete the authorization form.

1. Press the ‘Get Form’ button to access the form and open it in an editing interface.
2. Begin by filling out the patient information section. Clearly enter the last name, first name, middle initial, date of birth, and preferred phone number of the person whose health information is being released.
3. Next, specify the person or organization that will be receiving or releasing the health information. Fill in the name or facility, complete address, city, state, zip code, and a contact phone number. Remember to choose whether you are authorizing the release or the obtaining of information by selecting only one option.
4. Identify the type of information that needs to be released by checking the pertinent boxes, such as office visit notes or immunizations. Clearly specify any other needed information in the provided space.
5. Fill in the dates of the information you would like to be released. Ensure that the date range is appropriate, without including future dates.
6. Select how you would like the information to be released by choosing one of the available methods: mail, fax, pick-up, verbal/phone, or email. Be sure to provide any necessary information, such as an address or fax number in the previous section.
7. Indicate the purpose of the release by selecting one of the provided options, such as personal use or continued health care.
8. Finally, review your entries for accuracy and completeness. Sign and date the form, ensuring your signature aligns with your status as the patient or as a legal representative, if applicable.
9. Once completed, save any changes made to the form. You can then download, print, or share it as needed.

Complete your OSU SHS Authorization For Release Of Health Information online today to ensure your healthcare needs are met.