Recordkeeping and accountability are central to HIPAA compliance. Healthcare consumers have the right to limit how their personal health information is used. To make sure the privacy of consumers is protected, healthcare providers must have written authorization from individual consumers before releasing protected information.

The HIPAA Authorization for Use or Disclosure of Protected Health Information form allows employers to collect and record the required authorizations. By using clear language and a simple format, this convenient form streamlines the administrative process and helps ensure compliance with the law.

• This forms is 8.5" x 11"
• 50 sheets/pkg