This form authorizes the release of plaintiff's confidential medical records to plaintiff's attorney.
Iowa Authorization to Release Confidential Records
State:
Multi-State
Control #:
US-PI-0312
Format:
Word;
Rich Text
Instant download
Description
How to fill out Authorization To Release Confidential Records?
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FAQ
Submitting a request for public records Please email your request to hhsopenrecords@idph.iowa.gov. When submitting a request, please provide as many specific details as possible so that we may locate the record(s) quickly and efficiently. HHS will respond to your request within 10 business days.
Any person may submit their request to inspect public records to the Office of the Chief Information Officer by submitting their request through our Iowa Information and Public Records Request Portal, in person at the Office of the Chief Information Officer, e-mail, or by mail.
Child and Dependent Adult Abuse Information Complete a separate form for each person for whom information is requested and email to dhsabuseregistry@dhs.state.ia.us, or fax to (515) 564-4112, or mail to the Iowa Department of Human Services, Central Abuse Registry, P.O. Box 4826, Des Moines, IA 50305.
