The releasor authorizes his/her employer to release employment references including, but limited to, his/her employment history and wages and any information which may be requested relative to his/her employment, employment applications, and other related matters, and to furnish copies of any and all records which the employer may have regarding his/her employment.
Release Of Information Form Colorado In Phoenix
Category:
State:
Multi-State
City:
Phoenix
Control #:
US-00458
Format:
Word;
Rich Text
Instant download
Description
Form popularity
FAQ
Colorado Laws for Adults' Medical Record Retention The Medical Board of Colorado recommends retaining all patient records for a minimum of seven years after the last date of treatment.
(B) The health-care provider must provide the medical records in electronic format if the person requests electronic format, the original medical records are stored in electronic format, and the medical records are readily producible in electronic format.
If you have questions or need instructions on how to request your medical record by alternate means, then please contact Medical Records Management at (303) 312-9799 or records@coloradocoalition. Authorization to Disclose Protected Health Information (PHI) Form, CLICK HERE.
Check their website: Information about how to get your health record may be found under the Contact Us section of a provider's website. It may direct you to an online portal, a phone number, an email address, or a form. Phone or visit: You can also call or visit your provider and ask them how to get your health record.
If you are requesting your own health and/or behavioral health records or a designated representative is requesting on your behalf, the following will need to be provided: A valid authorization form that specifies what records are being requesting. A copy of your current, valid photo ID.
Unless otherwise required by statute or by federal law, a health care provider shall retain the original or copies of a patient's medical records as follows: 1. If the patient is an adult, for at least six years after the last date the adult patient received medical or health care services from that provider.
Who owns my medical record? Under Arizona law, your health care provider owns the original medical record. However, you have the right to see and get a copy of it.
A health care provider may only disclose that part or all of a patient's medical records and payment records as authorized by state or federal law or written authorization signed by the patient or the patient's health care decision maker.
