Home
Forms Library
Authorization described

Authorization described 2025

authorization described Preview on Page 1

See details

4.9 out of 5

476 votes

The document is a HIPAA Authorization Form that allows individuals over 18 to authorize the use and disclosure of their Protected Health Information (PHI). It includes sections for personal information, details about the PHI being authorized, entities involved in the use or disclosure, purpose of authorization, expiration and revocation rights, and a signature section. The form emphasizes that providing authorization is voluntary and outlines the implications of granting such authorization.

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 HIPAA Authorization 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 HIPAA Authorization in the editor.
In Section A, enter your name, mailing address, city, state, zip code, telephone number, and either your Social Security number or Participant ID number as assigned by WageWorks.
Move to Section B and specify the Protected Health Information (PHI) that you are authorizing for use or disclosure. If applicable, check the box indicating this authorization is for psychotherapy notes.
List the entities or persons authorized to use or disclose your PHI. Be specific about who can access this information.
Identify the persons or organizations authorized to receive your PHI. Clearly describe these entities.
State the purpose of this authorization in the designated area. You may choose 'At request of individual' or specify another purpose.
In Section C, indicate when this authorization will expire by completing the date field or describing an event that will trigger expiration.
Sign and date Section D to confirm your understanding and authorization of the use/disclosure of your PHI. If applicable, have a personal representative sign as well.

Start filling out your HIPAA Authorization form online for free today!

See more authorization described versions

We've got more versions of the authorization described form. Select the right authorization described version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2012	4.9 Satisfied (476 Votes)
2010	3.7 Satisfied (35 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 do you mean by authorization?

Authorization is the process of allowing an entity to have access to something or perform specific actions in a computer system. In a multi-user system, the system administrator uses the authorization mechanism to define permissions for each user or group of users.

What best describes authorization?

Access control uses the authorization process to either grant or deny access to systems or data. In other words, authorization defines policies on what a user or service may access.

How is authorization defined in healthcare?

A HIPAA authorization is a detailed document in which specific uses and disclosures of protected health are explained in full. By signing the authorization, an individual is giving consent to have their health information used or disclosed for the reasons stated on the authorization.

What is authorization details?

Authorization refers to the process of granting or denying access to a system, resource, or network to an authenticated user or entity based on its identity, roles, or permission.

What does it mean to authorize information?

: to endorse, empower, justify, or permit by or as if by some recognized or proper authority (such as custom, evidence, personal right, or regulating power) a custom authorized by time. 2. : to invest especially with legal authority : empower.

What are the details of the authorization letter?

The format of a letter of authorization should include the senders information, a date, the recipients details, an introduction, the body of the letter containing the authorization details, and a signature.

How do you explain authorization?

Authorization is the process of giving someone the ability to access a resource. Of course, this definition may sound obscure, but many situations in real life can help illustrate what authorization means so that you can apply those concepts to computer systems. A good example is house ownership.

What is an example of an authorization?

A good example is house ownership. The owner has full access rights to the property (the resource) but can grant other people the right to access it. You say that the owner authorizes people to access it. This simple example allows us to introduce a few concepts in the authorization context.

Authorization described 2025

Here's how it works

How to use or fill out HIPAA Authorization with our platform