Create your Health Information Release Form from scratch

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Here's how it works

01. Start with a blank Health Information Release Form
Open the blank document in the editor, set the document view, and add extra pages if applicable.
02. Add and configure fillable fields
Use the top toolbar to insert fields like text and signature boxes, radio buttons, checkboxes, and more. Assign users to fields.
03. Distribute your form
Share your Health Information Release Form in seconds via email or a link. You can also download it, export it, or print it out.

Design your Health Information Release Form in a matter of minutes

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Step 1: Access DocHub to build your Health Information Release Form.

Begin signining into your DocHub account. Try out the pro DocHub functionality at no cost for 30 days.

Step 2: Navigate to the dashboard.

Once logged in, head to the DocHub dashboard. This is where you'll create your forms and handle your document workflow.

Step 3: Create the Health Information Release Form.

Hit New Document and choose Create Blank Document to be taken to the form builder.

Step 4: Design the form layout.

Use the DocHub features to insert and arrange form fields like text areas, signature boxes, images, and others to your form.

Step 5: Add text and titles.

Add necessary text, such as questions or instructions, using the text tool to guide the users in your form.

Step 6: Customize field properties.

Modify the properties of each field, such as making them required or formatting them according to the data you plan to collect. Assign recipients if applicable.

Step 7: Review and save.

After you’ve managed to design the Health Information Release Form, make a final review of your form. Then, save the form within DocHub, transfer it to your chosen location, or distribute it via a link or email.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
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A signature and date that the authorization is signed by an individual or an individuals representative. If a representative is signing the form, the relationship with the patient must be detailed along with a description of the representatives authority to act on behalf of the patient.
Q: Do I need to docHub the signed form? A: No. The HIPAA Privacy Rule does not require you to docHub authorization forms or have a witness. Though taking the time to fill out an authorization form and get a patients signature is an extra step, its an important one that you cant afford to overlook.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations established national privacy standards for health care information. HIPAA prohibits the release of information without authorization from the patient except in the specific situations identified in the regulations.
Form 815 - Universal HIPAA Authorization - English.
The purpose for which the information will be disclosed. The name of the person or entity to whom the information will be disclosed. An expiration date or expiration event when consent to use/disclose the information is withdrawn. For example, an expiration event may be when a research study is completed.
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Related Q&A to Health Information Release Form

A HIPAA-compliant HIPAA release form must, at the very least, contain the following information: A description of the information that will be used/disclosed. The purpose for which the information will be disclosed. The name of the person or entity to whom the information will be disclosed.