Hipaa form printable 2026

See details

4.2 out of 5

44 votes

The document is a HIPAA Release form that authorizes the disclosure of an individual's health information to specified agents. It allows named individuals to access the patient's medical records without restrictions, superseding any previous agreements regarding confidentiality. The authorization does not expire unless revoked in writing by the patient.

Here's how it works

01. Edit your hipaa fillable form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out hipaa form printable with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the HIPAA Release in the editor.
Begin by filling in your name in the designated space at the top of the form. This identifies you as the patient granting authorization.
In the section for authorized persons, list the names, addresses, and relationships of individuals who are permitted to access your health information.
Review the statement regarding disclosure of your health information. Ensure you understand that this includes sensitive information related to mental health and other conditions.
Sign and print your name at the bottom of the form to validate your authorization.
If required, complete the notary section by providing details about your state and county, along with a date for notarization.

Start using our platform today to easily fill out and manage your HIPAA forms online for free!

be ready to get more

Complete this form in 5 minutes or less

Get form

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.

Is there a standard HIPAA form?

FormDr gives your business everything needed to easily send and receive HIPAA compliant forms online. Send patients your forms to fill out on their phone, tablet, or computer. Patients easily sign and submit completed forms securely online.

What is a HIPAA compliant form?

A HIPAA release form is a document that when signed allows healthcare providers to share a patients protected health information (PHI) with specified individuals or organizations, according to the details stipulated in the form.

Can you fill out a HIPAA form online?

A HIPAA release form is required when a covered entity shares a patients protected health information (PHI) with someone outside of treatment, payment, or healthcare operations. Common scenarios where a signed release form is required include: Sharing medical records with a family member.

Do I need to fill out a HIPAA form?

Begin by specifying your name, the entity authorized to disclose information, and the individuals or entities you authorize to receive it. Indicate the specific information and purpose for which it will be disclosed, add an expiration date or event, and sign and date the form to confirm your consent.

What is a HIPAA standard?

HIPAA sets strict standards for managing, transmitting, and storing protected health information. HIPAA applies to healthcare providers, insurers, and other organizations handling patient data, mandating safeguards to prevent unauthorized access or misuse of sensitive information.

Security and compliance

At DocHub, your data security is our priority. We follow HIPAA, SOC2, GDPR, and other standards, so you can work on your documents with confidence.

Learn more

How to make a form HIPAA compliant?

How to create effective HIPAA compliant authorization forms Using a HIPAA compliant forms builder. Collect HIPAA compliant electronic signatures. Collecting all patient information in digital patient intake forms online. Restricting form field entry. Making form fields required. Using conditional logic in forms.

What is the standard HIPAA authorization?

Authorization. A covered entity must obtain the individuals written authorization for any use or disclosure of protected health information that is not for treatment, payment or health care operations or otherwise permitted or required by the Privacy Rule.

Hipaa form printable 2026

Here's how it works