This form authorizes the release of plaintiff's confidential medical records to plaintiff's attorney.
Utah 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
You have the right to get medical care no matter what your race, color, nationality, disability, sex, religion, or age. You have the right to receive information on all available treatment options. You have the right to take part in decisions regarding your medical care, including refusing treatment.
Your medical records actually belong to the doctor, hospital, or other place that made them, not to you. That's also true for dental records and nursing home records. But the information in the medical records belongs to you. You have a right to see that information.
$32.10* per request for locating a patient's records; b. 57 cents* per page for the first 40 pages, and 34 cents* per page for each additional page; c.
If a patient wants to look at their medical record or get copies of their record, they may submit a written request to the Health Information Department. If the patient comes in person, they must bring government-issued, picture identification, such as a driver's license, passport, military card. Medical Records & Information Release University of Utah Health ? patient-family-services University of Utah Health ? patient-family-services
Who owns my medical record? Under Utah law, your health care provider owns the actual medical record. For example, if your provider maintains paper medical records, they own and have the right to keep the original record, but you have the right to see and get a copy of it. Your Medical Record Rights in Utah cyrss.com ? docs ? hipaa ? StateHIP cyrss.com ? docs ? hipaa ? StateHIP
Generally, your health care provider must give you a copy in the format that you request if they are able to do so. Your provider may charge you a fee to copy your medical record. Your Medical Record Rights in Louisiana cyrss.com ? docs ? hipaa ? StateHIP cyrss.com ? docs ? hipaa ? StateHIP
(7) Medical records shall be retained for at least seven years after the last date of patient care. Records of minors shall be retained until the minor reaches age 18 or the age of majority plus an additional two years. In no case shall the record be retained less than seven years.
