Sample HIPAA Authorization Form for Family Members/Friends 2025

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A HIPAA-compliant HIPAA release form must, at the very least, contain the following information: A description of the information that will be used/disclosed. The purpose for which the information will be disclosed. The name of the person or entity to whom the information will be disclosed.
The HIPAA Privacy Rule at 45 CFR 164.510(b) permits covered entities to share with an individuals family member, other relative, close personal friend, or any other person identified by the individual, the information directly relevant to the involvement of that person in the patients care or payment for health care.
Yes, HIPAA does allow verbal consent in specific situations. While the general rule mandates written authorization for the use and disclosure of protected health information (PHI), exceptions exist.
The HIPAA Right of Access Form for Family Members is designed to allow patients to share their health information with designated individuals.
Yes. If the patient is not present or is incapacitated, a health care provider may share the patients information with family, friends, or others as long as the health care provider determines, based on professional judgment, that it is in the best interest of the patient.