Alabama Release of Information, Records Consent is a form that individuals must complete and sign before they can access medical information related to themselves or a family member. It allows an individual to authorize the release of protected health information (PHI) to a specific person, organization, or institution. The form must be signed by both the patient and their legal representative. There are two types of Alabama Release of Information, Records Consent forms: 1) General Release of Information Consent and 2) Specific Release of Information Consent. The General Release of Information Consent form allows a patient to provide consent for the release of all PHI that is relevant to their situation. The Specific Release of Information Consent form allows a patient to authorize the release of specific PHI to a specific person, organization, or institution. Both forms require the patient's signature and the signature of their legal representative.
Alabama Release of Information, Records Consent
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Release of Information, Records Consent
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The medical record information release (HIPAA) form allows a patient to give authorization to a 3rd party and access their health records. Complete this form only if you want us to give information or records about you, a minor, or a legally incompetent adult, to an.This authorization is given in compliance with the federal consent requirements for release of alcohol or substance abuse records of 42 CFR 2. We will not release records if you submit an incomplete form. If you need assistance completing the form, please contact our office at 814-949-5540. The signature of a minor patient is required for the release of some of these items. Newly Released FAQs on Access Guidance. Please download, complete and sign the form and send to Health Information Management (HIM). Records released may include information received from other organizations. This form is not a patient access request under 45 CFR 164.524.