OCFS-8001: Authorization for Release of Health Information - ocfs ny-2025

See details

4.4 out of 5

29 votes

The document OCFS-8001 is an authorization form from the New York State Office of Children and Family Services for the release of health information related to a child's participation in the Bridges to Health (B2H) Home & Community Based Services Medicaid Waiver Program. It outlines the rights of the individual regarding the disclosure of sensitive health information, including mental health, substance abuse, and HIV-related data, while ensuring compliance with state and federal privacy laws. The form requires specific details about the child, authorized representatives, and intended recipients of the information.

Here's how it works

01. Edit your health department nys 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 nys services via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out OCFS-8001: Authorization for Release of Health Information - ocfs ny 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 OCFS-8001 in the editor.
Begin by entering the child's name, sex, date of birth, and Medicaid CIN # in the designated fields at the top of the form.
In section 7, provide the name and complete address of the health provider or entity that will release the information.
Next, specify in section 8 who will receive this information by filling out their name and address.
In section 9(a), indicate what specific information you wish to be released by initialing the appropriate boxes. Be sure to include dates for medical records if applicable.
If you want to authorize discussions about your health information, initial in section 9(b) and provide the name of the individual or entity authorized to discuss it.
Complete sections 10 through 13 regarding the reason for release, expiration date, and signatures. Ensure all required signatures are provided before submitting.

Start using our platform today to easily fill out your OCFS-8001 form online for free!

See more OCFS-8001: Authorization for Release of Health Information - ocfs ny versions

We've got more versions of the OCFS-8001: Authorization for Release of Health Information - ocfs ny form. Select the right OCFS-8001: Authorization for Release of Health Information - ocfs ny version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2011	4.4 Satisfied (29 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 is authorization for release of protected health information?

Generally, an authorization provides the authority for a doctors release of PHI for specified purposes, which are generally other than treatment, payment, or healthcare operations, or, to disclose protected health information to a third party specified by the individual.

How do I give someone a HIPAA authorization?

Authorization Core Elements The name(s) or specific identification of the person(s) or class of person(s) who will use the PHI or to whom the covered entity will make the disclosure. Description of each specific purpose of the requested disclosure.

How do you write an authorization letter for medical records release?

I, the undersigned, authorize the release of, or request access to the information specified below from the medical record(s) of the above name patient. I understand that my records are confidential and cannot be disclosed without my written authorization, except when otherwise permitted by law.

How to fill out an authorization for release of protected 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.

What is an authorization for release of medical information?

An authorization for release of medical information form is a signed document that gives a healthcare provider permission to release a patients medical records. This consent is required by law in many countries to protect the patients sensitive data.

information nys

Ocfs 8001 authorization for release of health information ocfs ny form Ocfs 8001 authorization for release of health information ocfs ny online Authorization to release information form PDF Consent to release information form Medical records request form (PDF) Ny HIPAA form Release of information form Mental Health Helio Health Release of information

How to write an authorization to release information?

I understand that I have the right to inspect or have a copy of the confidential information I have authorized to be used or disclosed by this authorization form. I understand that if I agree to sign this authorization, which I am not required to do, I must be provided with a signed copy of the form.

What is an example of a HIPAA authorization?

I hereby authorize use or disclosure of protected health information about me as described below. 4. 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.