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  • Oh Cincinnati Childrens Authorization For Use And/or Disclosure Of Protected Health Information 2021

Get Oh Cincinnati Childrens Authorization For Use And/or Disclosure Of Protected Health Information 2021-2025

Authorization for Use and/or Disclosure of Protected Health Information (PHI) MEDICAL RECORD #: CSN / ACCT #: (completed by CCHMC)Patient InformationThis form authorizes Cincinnati Childrens.

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By completing the Authorization to Verbally Discuss Protected Health Information Form, it will allow us to talk about your medical care to those you have designated. This includes appointment and scheduling information, lab and test results, treatment information, and billing information.

A HIPAA authorization is consent obtained from an individual that permits a covered entity or business associate to use or disclose that individual's protected health information to someone else for a purpose that would otherwise not be permitted by the HIPAA Privacy Rule.

If your child is 18 years of age or older, it is REQUIRED by law that he or she sign a “Authorization for Use and / or Disclosure of Protected Health Information” form allowing release of the medical record, including to release the record to you.

Authorization. A covered entity must obtain the individual's written authorization for any use or disclosure of protected health information that is not for treatment, payment or health care operations or otherwise permitted or required by the Privacy Rule.

A Privacy Rule Authorization is an individual's signed permission to allow a covered entity to use or disclose the individual's protected health information (PHI) that is described in the Authorization for the purpose(s) and to the recipient(s) stated in the Authorization.

A: “Consent” is a general term under the Privacy Rule, but “authorization” has much more specific requirements. The Privacy Rule permits, but does not require, a CE to obtain patient “consent” for uses and disclosures of PHI for treatment, payment, and healthcare operations.

For help with medical records or more information about the Health Information Management Department at Cincinnati Children's, contact us at 513-636-4217.

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© Copyright 1997-2025
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3720 Flowood Dr, Flowood, Mississippi 39232
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
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
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