Get Canada Sha 0249 - Saskatchewan 2019-2026

This guide provides a step-by-step approach to completing the Canada SHA 0249 form for the consent to disclose personal health information in Saskatchewan. By following these instructions, you can successfully navigate the online process with confidence.

Follow the steps to complete the consent form online.

1. Press the ‘Get Form’ button to obtain the Canada SHA 0249 form and access it in the editor.
2. In the authorization section, enter your full name as the patient, guardian, or legal representative. Specify the program or facility that you authorize to release the health information.
3. Indicate the name of the person, company, or agency authorized to receive the health information. Provide their relationship to the patient if they are not the patient.
4. Complete the authorizer’s telephone number field by entering a contact number where you can be reached during business hours.
5. Next, in the 'Whose information is being requested?' section, fill out the patient's first and last name as it appears on their health card, along with their health services number and date of birth.
6. In the 'Personal health information requested' section, detail the specific records or information you are requesting. Include the name of the facility that provided services and the dates when those services were delivered.
7. Provide the complete address of the person, company, or agency authorized to receive the health information. Include the province/state, town/city, country, telephone number, and postal or zip code.
8. Choose how you wish to receive the records, either by receiving copies of originals, picking them up, faxing them, or having them mailed to the specified address.
9. Sign and date the request at the bottom of the form to validate your authorization.
10. After filling out the entire form, make sure to save your changes. You may also download, print, or share the form as needed.

Begin completing your consent for disclosure form online today.