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Washington Sealed Personal Health Care Records (Cover Sheet)

Washington Sealed Personal Health Care Records (Cover Sheet)

Name: Washington Sealed Personal Health Care Records (Cover Sheet)
Brand: US Legal Forms
Price: 59.00 USD
Rating: 4.81 (241 reviews)

Category:

Washington Local County - King - Superior Court - Miscellaneous

State:

Washington

Control #:

WA-SKU-0645

Format:

Instant download

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Public form

Description

Sealed Personal Health Care Records (Cover Sheet) Washington Sealed Personal Health Care Records (Cover Sheet) is a form used in the state of Washington to protect the privacy of a patient's medical records. The form is required by law and must be filled out by the patient or legal representative. It must be signed by both the patient or legal representative and the health care provider. The form includes the patient's name, date of birth, diagnosis, services rendered, and any other information that is relevant to the patient's care. It also specifies who can access the records and for what purpose. The form must be sealed and kept confidential. Different types of Washington Sealed Personal Health Care Records (Cover Sheet) include the Patient Authorization Form, Medical Record Release Form, and the Authorization for Release of Information Form.

Washington Sealed Personal Health Care Records (Cover Sheet) is a form used in the state of Washington to protect the privacy of a patient's medical records. The form is required by law and must be filled out by the patient or legal representative. It must be signed by both the patient or legal representative and the health care provider. The form includes the patient's name, date of birth, diagnosis, services rendered, and any other information that is relevant to the patient's care. It also specifies who can access the records and for what purpose. The form must be sealed and kept confidential. Different types of Washington Sealed Personal Health Care Records (Cover Sheet) include the Patient Authorization Form, Medical Record Release Form, and the Authorization for Release of Information Form.

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How to fill out Washington Sealed Personal Health Care Records (Cover Sheet)?

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FAQ

If your medical record is not available online, you may request a copy in writing from your provider. The simplest way to do this is to call and ask how to request a copy of your records. You may also be able check their website online and see if they have a release of records form available for you to fill out.

In general, the first 20 pages of a paper version of a medical record may cost approximately one dollar per page, and each additional page may cost between 10 cents to 80 cents per page.

Simple, small records requests are often free. Under HIPAA, providers can't charge you for the labor of searching or retrieving records.

Your provider can charge a "reasonable fee" for your copies. You may have to pay up front. In 2022, a health care provider can charge up to $1.24 a page for the first thirty pages, 94 cents a page after that, and a $28 clerical fee. WAC 246-08-0400.

Contact our public records officer by email at PRD@doh.wa.gov or phone at 360-236-4220.

How long does my doctor keep my medical record? Check with your provider regarding the length of record retention. Washington State Law requires hospitals to retain medical records which are related to the care and treatment of the patient for a period of not less than 10 years following the most recent discharge.

Washington medical records laws state that only the patient may authorize disclosure of medical records to anyone other than health care providers, penal institution officials, or public health authorities.

(a) No more than one dollar and twenty-four cents per page for the first thirty pages; (b) No more than ninety-four cents per page for all other pages.

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Use this form as a cover sheet to keep your personal health information private from the public. (Cover Sheet). (SEALPHC).Clerk's Action Required. Instant access to fillable Microsoft Word or PDF forms. Minimize the risk of using outdated forms and eliminate rejected fillings. For use in Family Law and Guardianship cases. Sealed Personal Health Care Records. Please download the form(s) you need and open in Acrobat Reader. All forms must be completed and submitted in English. Form NumberForm NameCategoryAO 10AFinancial Disclosure Report RequestOther FormsAO 30Certified CopyOther FormsAO 35Certificate of Official Court ReporterCourt Reporter Forms

Washington Sealed Personal Health Care Records (Cover Sheet)

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