Medical Authorization Withdrawal In Washington
Category:
State:
Multi-State
Control #:
US-00426
Format:
Word;
Rich Text
Instant download
Description
The Medical Authorization Withdrawal in Washington form allows patients to formally revoke previously granted permissions for their medical information to be shared. This document instructs healthcare providers not to disclose any medical information to others without written consent, ensuring privacy and control over medical records. It includes key features such as a clear statement of revocation of prior authorization and stipulations regarding HIPAA compliance. Users must fill in their personal information, including the date and the recipient of the medical information, typically an attorney. The form must be signed and dated by the patient to be valid. This withdrawal is particularly relevant for attorneys, partners, owners, associates, paralegals, and legal assistants working with clients in personal injury cases or other legal matters where medical records are necessary. By utilizing this form, legal professionals can maintain the confidentiality of their clients while ensuring compliance with healthcare laws. It serves as an essential tool for any legal representative who requires medical information but must respect the patient's right to withdraw authorization at any time.
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