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North Carolina Authorization for Release of Medical Information for Criminal Cases

State:
North Carolina
Control #:
NC-00426
Format:
Word; 
Rich Text
Instant download

Description

This authorization is given to a healthcare provider by a patient treated for an injury or treatment pertinent to a criminal case in state court. Authorization is given to release specific records and reports to the district attorney, prosecutor, defense attorney, or law enforcement agency.

North Carolina Authorization for Release of Medical Information for Criminal Cases is a legal document that allows health care providers to release confidential medical records to law enforcement and other authorities for the purpose of criminal cases. This document is signed by both the patient and the authorized healthcare provider and must be witnessed and notarized before it is valid. There are two types of North Carolina Authorization for Release of Medical Information for Criminal Cases: the single-use authorization and the blanket authorization. The single-use authorization allows the healthcare provider to release medical records related to a specific incident or criminal matter, while the blanket authorization allows for the release of medical records related to all criminal cases. The North Carolina Authorization for Release of Medical Information for Criminal Cases is a necessary document in order to ensure that the patient's medical information is kept confidential and is not used for any other purpose than what is outlined in the document.

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FAQ

Include signature, printed name, date, and records desired. Release a copy only, not the original. The physician may prepare a summary of the medical record, if acceptable to the patient.

In general, under the provisions of the FOIA and Privacy Act, access to information about private individuals cannot be given to unauthorized third parties without the individual's written consent. If you provide authorization, your request will be processed with the greatest possible access.

In North Carolina you have the right to: See and get a copy of your medical record. you a copy of it within 30 days after they receive your request. In most cases, your health care provider is allowed to charge you a reasonable, cost-based fee for copying your record.

The physician may photocopy and send all records, or may send a summary. The patient must sign an authorization to release records.

The Health Insurance Portability and Accountability Act of 1996 was put in place to help ensure privacy and yet ease of access to your medical records. A HIPAA Authorization Form is a document that allows a medical provider to share specific health information with another person or group.

The law generally bars health care professionals from sharing a patient's medical records without receiving written permission from the patient. When you start seeing a new medical provider, the provider will ask you to sign a release form that grants permission for certain staff members to access your record.

The custodian must determine whether to release the record, what portions of the record should be released, and whether the record is admissible as evidence. However, the custodian of an EHR has several additional concerns when an EHR is involved in litigation.

More info

The medical record information release (HIPAA) form allows a patient to give authorization to a 3rd party and access their health records. Providing individuals with easy access to their health information empowers them to be more in control of decisions regarding their health and well-being.The Privacy Rule, a Federal law, gives you rights over your health information and sets rules and limits on who can look at and receive your health information. This form is used to advise Medicare of the person or persons you have chosen to have access to your personal health information. Note: A single Authorization form may not be used to authorize the release of Psychotherapy Notes and other medical records. Note: A single Authorization form may not be used to authorize the release of Psychotherapy Notes and other medical records. To obtain your medical records, you will need to complete an Authorization for Release of Protected Health Information Form (Spanish, Polish). A patient's medical records can only be accessed or released with proper authorization from the patient or the patient's legal representative. AUTHORIZATION TO RELEASE CONFIDENTIAL INFORMATION, Client Name. Michigan Department of Health and Human Services.

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North Carolina Authorization for Release of Medical Information for Criminal Cases