This form authorizes the release of plaintiff's confidential medical records to plaintiff's attorney.
New Hampshire 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
The patient shall be fully informed by a health care provider of his or her medical condition, health care needs, and diagnostic test results, including the manner by which such results will be provided and the expected time interval between testing and receiving results, unless medically inadvisable and so documented ...
The New Hampshire Right to Know Law is a series of statutes designed to guarantee that the public has access to public records of governmental bodies. Public records are any information created, accepted, or obtained by, or on behalf of, any public body.
The Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) are two examples of federal laws that regulate privacy and the exchange of specific types of information.
Public criminal conviction history maintained in the central repository can be disseminated upon request to anyone for a fee. Confidential Criminal History Information, including non-conviction data, can be disseminated only to Law enforcement personnel, or a person requesting his or her own record.
Generally, health care providers may charge you for copying your medical record. In New Hampshire, your provider is allowed to charge you no more than $15 for the first 30 pages or $. 50 per page, whichever is greater. Your provider can also charge you the actual cost of postage if you have the copies sent to you.
STATE LAW, RSA 332-I, allows patients to obtain a copy of their medical records for a limited charge. RSA 332-I states the following: ?332-I:1 Medical Records. ? All medical information contained in the medical records in the possession of any health care provider shall be deemed to be the property of the patient.
If you have any questions regarding Criminal Record Requests, please call (603) 223-3867.
