This form is used to certify the authenticity of medical records provided to the attorney by a medical provider.
Washington Certificate of Authenticity of Medical Records
State:
Multi-State
Control #:
US-PI-0013
Format:
Word;
Rich Text
Instant download
Description
How to fill out Certificate Of Authenticity Of Medical Records?
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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.
010 the fees a provider may charge cannot exceed the fees listed below: (1) Copying charge per page: (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.
RCW 70.02.030 A health care provider shall honor an authorization and, if requested, provide a copy of the recorded health care information unless the health care provider denies the patient access to health care information under RCW 70.02.
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 HIPAA authorization is consent obtained from an individual that permits a covered entity or business associate to use or disclose that individual's protected health information to someone else for a purpose that would otherwise not be permitted by the HIPAA Privacy Rule.
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 patient may revoke in writing a disclosure authorization to a health care provider at any time unless disclosure is required to effectuate payments for health care that has been provided or other substantial action has been taken in reliance on the authorization.
010 the fees a provider may charge cannot exceed the fees listed below: (1) Copying charge per page: (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.
