Home
Forms Library
Hawaii HIPAA Medical Release Form

Hawaii HIPAA Medical Release Form 2026

Hawaii HIPAA Medical Release Form Preview on Page 1

See details

4.8 out of 5

54 votes

The document is a HIPAA Authorization form for the release of personal health information in Hawaii. It allows individuals to specify which health information they wish to disclose, identify recipients of that information, and state the reason for disclosure. The form also outlines the individual's right to revoke the authorization and provides instructions for doing so. It emphasizes that signing the authorization is voluntary and details potential re-disclosure risks.

Here's how it works

01. Edit your 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 Hawaii HIPAA Medical Release Form with DocHub

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the Hawaii HIPAA Medical Release Form in our editor.
Begin by entering your personal information in the designated fields, including your name, phone number, address, and member number. This ensures that the form is accurately linked to your health records.
In the section for personal health information, specify what information you wish to release. You can provide specific details such as 'claims information related to my hip surgery' or opt for broader terms like 'all my health information.' Remember to use a separate form for psychotherapy notes if needed.
Identify the individuals or organizations authorized to receive your health information by filling in their names and addresses. This step is crucial for ensuring that your data is shared only with trusted parties.
State the reason for this disclosure clearly. Examples include 'to answer questions about my claims' or 'for legal purposes.' This helps clarify the context of the release.
Review the revocation rights section carefully. Understand that you can revoke this authorization at any time and note how long this authorization will remain valid.
Finally, sign and date the form at the bottom. Ensure all fields are completed before submitting it through our platform for a seamless process.

Start using our platform today to easily fill out and manage your Hawaii HIPAA Medical Release Form 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.

Does a HIPAA release form have to be docHubd?

Hawaii Data BdocHub Notification Law The HIPAA BdocHub Notification Rule requires healthcare organizations to report bdocHubes that compromise the confidentiality, integrity, or availability of protected health information. Incidents that are considered reportable bdocHubes include: Hacking or IT incidents.

How to complete a HIPAA release 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.

What is the 1.5 medical rule in Hawaii?

In Hawaii, an employer can elect to pay the entire premium amount or share the cost with the employee. The employer must pay for at least one-half of the (single) premium cost, however, the employees contribution cannot exceed 1.5% of the employees monthly wages.

How to report a HIPAA violation in Hawaii?

Complaint Requirements Your complaint must: Be filed in writing by mail, fax, e-mail, or via the OCR Complaint Portal. Name the covered entity or business associate involved, and describe the acts or omissions, you believed violated the requirements of the Privacy, Security, or BdocHub Notification Rules.

What is the HIPAA law in Hawaii?

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.

What qualifies as a HIPAA violation?

A HIPAA violation is any failure to comply with the HIPAA regulations which can include the unauthorized access, use, or disclosure of Protected Health Information (PHI), the failure to provide patients with access to their PHI, a lack of safeguards to protect PHI, the failure to conduct regular risk assessments, or

What is the Romeo and Juliet law in Hawaii?

Persons at least 14 years old and less than 16 years old can consent to sexual activity with a person who is less than five years older. For example, a person who just turned 14 years old cannot consent to sexual activity with a person who is about to turn 20 years old.

Hawaii HIPAA Medical Release Form 2026

Here's how it works