Home
Forms Library
Johns hopkins medical records

Authorization to Release Protected Health Information 2025

johns hopkins medical records Preview on Page 1

Show details

4.9 out of 5

46 votes

The document is an authorization form from Johns Hopkins Hospitals for the release of protected health information (PHI) under HIPAA regulations. It outlines the necessary details for patients to request their health information, including personal identification, the specific actions requested (such as obtaining copies or discussing information), and the types of health records involved. The form also includes important legal disclaimers regarding the handling of sensitive information and patient rights.

Here's how it works

01. Edit your johns hopkins medical records 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 change Authorization to Release Protected Health Information online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

With DocHub, making adjustments to your paperwork requires just a few simple clicks. Follow these fast steps to change the PDF Authorization to Release Protected Health Information online free of charge:

Register and log in to your account. Log in to the editor using your credentials or click Create free account to evaluate the tool’s features.
Add the Authorization to Release Protected Health Information for editing. Click on the New Document option above, then drag and drop the sample to the upload area, import it from the cloud, or via a link.
Adjust your file. Make any adjustments needed: add text and photos to your Authorization to Release Protected Health Information, highlight important details, remove sections of content and replace them with new ones, and add icons, checkmarks, and areas for filling out.
Finish redacting the template. Save the updated document on your device, export it to the cloud, print it right from the editor, or share it with all the people involved.

Our editor is super intuitive and efficient. Give it a try now!

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 is a HIPAA authorization?

A HIPAA Authorization form is a formal document used to obtain a persons signed permission for a covered entity (e.g., a healthcare provider) to use and disclose their protected health information (PHI) for a purpose that is not otherwise permitted under the HIPAA Privacy Rule.

What is an example of authorization process?

So, if you assign permission to furnish your house to your interior decorator, you are granting them that privilege. Sometimes authorization is somewhat related to identity. Think of the process of boarding a plane. You have your boarding pass that states you are authorized to fly with that plane.

What is an example of a Hipaa authorization?

I hereby authorize use or disclosure of protected health information about me as described below. I understand that the information used or disclosed may be subject to re-disclosure by the person or class of persons or facility receiving it, and would then no longer be protected by federal privacy regulations.

What is a HIPAA example?

Complex examples of HIPAA violations ing to HIPAA, patients have a right to their medical records within 30 days of a request; failure to provide them is a HIPAA violation. Losing a device or record that exposes patient records to unauthorized actors is also a HIPAA violation.

What is the authorization for release of protected health information in California?

(a) Patients may authorize the release of their health care information by completing the CDCR 7385, Authorization for Release of Protected Health Information, to allow a family member or friend to request and receive an update when there is a significant change in the patients health care condition.

How do you write an authorization to release information?

Content for a valid authorization includes: The name of the person or entity authorized to make the request (usually the patient) The complete name of the person or entity to receive the protected health information (PHI) A specific description of the information to be used or disclosed, including the dates of service.

What is an example of authorization in it?

To take a simple example: A user logs into a business application, providing their company username and password. The application authenticates the user and verifies the password. The application checks what permissions are allocated to that username and grants access to the relevant data and features.

Authorization to Release Protected Health Information 2025

Here's how it works