ComplyRight HIPAA Patient Consent and Authorization for Release of PHI Form - 200/Pack
Item number 529a1350MFR number A1350
$40.49/Pack$0.20/Each
Ships free with
Usually Ships in 2 Business Days from manufacturer
Lead times vary based on manufacturer stock
Product Overview
- Required to be given to patients under HIPAA law
- Includes all HIPAA required elements for obtaining authorization to disclose PHI
- A patient's written authorization must be obtained for use of protected health information
- Standard 8 1/2" x 11 size for easy filing
- Promotes safety and compliancy in medical settings
- Quantity
- 200/Pack
- Shipping Weight
- 0.77 lb.
- Length
- 11 Inches
- Width
- 8 1/2 Inches
- Features
- Made in America
- Language
- English
- Material
- Paper
- Shape
- Rectangle
- Type
- Medical Services Forms
ComplyRight A1350 Details
Keep your patients informed with this ComplyRight HIPAA patient consent and authorization for release of PHI form. This form allows healthcare providers to obtain authorization from patients regarding release of their personal health information that is not for treatment, payment, healthcare operations, or otherwise permitted/required by HIPAA privacy law. This patient authorization is a requirement for all healthcare providers and includes all elements that make the authorization valid.
This form should be handed out to patients before, during, or after visits. It is attorney approved, ensuring that it is up-to-date and legally compliant. Plus, at 8 1/2" x 11" in size, it can be easily stored in standard file cabinets for quick reference.
Overall Dimensions:
Length: 11"
Width: 8 1/2"
Because this item is not stocked in our warehouse, processing, transit times and stock availability will vary. If you need your items by a certain date, please contact us prior to placing your order. Expedited shipping availability may vary. We cannot guarantee that this item can be cancelled off of the order or returned once it is placed.
Attention CA Residents:
Made in America
This item was made in the United States of America.