PDF authorization - for use or disclosure of health information - Providence 2025

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The name(s) or other specific identification of the person or class of persons to whom information will be disclosed. A description of the purpose of the requested use or disclosure. In cases where a statement of the purpose is not provided, at the request of the individual is sufficient.
Final answer: A patients authorization for the disclosure of PHI must include the purpose and the information to be released when it relates to treatment for substance abuse.
HIPAA stipulates that there has to be a written authorization for every use or disclosure of PHI not required or permitted by the HIPAA Privacy Rule. In addition, the retraction of HIPAA authorization also has to be written.
When Must Patient Authorization be Obtained for Uses and Disclosures of PHI? Authorizations are generally required for psychotherapy notes, substance abuse disorder and treatment records, and for marketing purposes.
A Privacy Rule Authorization is an individuals signed permission to allow a covered entity to use or disclose the individuals protected health information (PHI) that is described in the Authorization for the purpose(s) and to the recipient(s) stated in the Authorization.
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