Home
Forms Library
Personal disclosure health information consent

SHA 0249 Consent for Disclosure of Personal Health Information-2025

personal disclosure health information consent Preview on Page 1

See details

4.7 out of 5

20 votes

The document outlines the process for obtaining consent to disclose personal health information by the Saskatchewan Health Authority (SHA). It details the necessary steps for patients or their authorized representatives to complete a consent form, including providing personal information, specifying the health information requested, and identifying the recipient of that information. The document also explains the authorization process, potential fees, and guidelines for submitting requests.

Here's how it works

01. Edit your personal disclosure health information consent 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 SHA 0249 Consent for Disclosure of Personal Health Information 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 SHA 0249 Consent for Disclosure of Personal Health Information in the editor.
In the 'Authorization' section, enter your full name as the patient, guardian, or legal representative. Specify the program or facility you are authorizing to release information.
Indicate the person, company, or agency authorized to receive the health information and provide their contact telephone number.
For 'Whose Information is Being Requested?', fill in the patient's first and last name as it appears on their health card, along with their Health Services Number and date of birth.
In 'Personal Health Information Requested', be specific about the records you need. Include details like service dates and locations to expedite processing.
Complete the address section for the recipient of the health information, ensuring all contact details are accurate.
Sign and date your request at the bottom of the form. Ensure you understand that proof of identity may be required before records are released.

Start using our platform today to easily complete your SHA 0249 form online for free!

See more SHA 0249 Consent for Disclosure of Personal Health Information versions

We've got more versions of the SHA 0249 Consent for Disclosure of Personal Health Information form. Select the right SHA 0249 Consent for Disclosure of Personal Health Information version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2022	4.7 Satisfied (20 Votes)
2019	4.7 Satisfied (38 Votes)

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.

What are the two conditions that allow patient information to be disclosed?

The general rule under the Privacy Act is that an agency cannot disclose a record contained in a system of records unless the individual to whom the record pertains gives prior written consent to the disclosure. There are twelve exceptions to this general rule.

What is consent to disclose and verify personal information?

A person can consent to the collection, use or disclosure of personal information for reasonable purposes (which is what a reasonable person would consider appropriate under the circumstances). Someone may consent verbally or in writing, including via electronic communications.

When can you disclose confidential information without consent?

A covered entity must disclose protected health information in only two situations: (a) to individuals (or their personal representatives) specifically when they request access to, or an accounting of disclosures of, their protected health information; and (b) to HHS when it is undertaking a compliance investigation or

When can health information be disclosed without consent?

Under the CMIA, medical information must be released when compelled: by court order. by a board, commission or administrative agency for purposes of adjudication. by a party to a legal action before a court, arbitration, or administrative agency, by subpoena or discovery request.

When can patient information be disclosed without consent?

You can share confidential information without consent if it is required by law, or directed by a court, or if the benefits to a child or young person that will arise from sharing the information outweigh both the public and the individuals interest in keeping the information confidential.

How to fill out authorization to use and disclose health information?

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.

SHA 0249 Consent for Disclosure of Personal Health Information-2025

Here's how it works

How to use or fill out SHA 0249 Consent for Disclosure of Personal Health Information with our platform

See more SHA 0249 Consent for Disclosure of Personal Health Information versions

Complete this form in 5 minutes or less

Got questions?

What are the two conditions that allow patient information to be disclosed?

What is consent to disclose and verify personal information?

When can you disclose confidential information without consent?

When can health information be disclosed without consent?

When can patient information be disclosed without consent?

Complete this form in 5 minutes or less

People also ask

How to fill out authorization to use and disclose health information?

Related links

Try more PDF tools

SHA 0249 Consent for Disclosure of Personal Health Information-2025

Here's how it works

How to use or fill out SHA 0249 Consent for Disclosure of Personal Health Information with our platform

See more SHA 0249 Consent for Disclosure of Personal Health Information versions

Complete this form in 5 minutes or less

Got questions?

What are the two conditions that allow patient information to be disclosed?

What is consent to disclose and verify personal information?

When can you disclose confidential information without consent?

When can health information be disclosed without consent?

When can patient information be disclosed without consent?

Related Searches

Related forms

Complete this form in 5 minutes or less

People also ask

How to fill out authorization to use and disclose health information?

Related links

Try more PDF tools