Release your Medical Record
Click in the right upper corner of the form to displayed in another window and print or download. You must sign this form to release your medical information
This authorization permits Miami Sonogram to release your health information to you or to healthcare providers, other than your Primary Care Physician, for the purposes of continued care and treatment.
You are required to sign this authorization and either submit it in person or complete the third-party authorization form if applicable.
In accordance with HIPAA regulations, healthcare providers are allowed to implement their own policies and procedures to verify the identity of individuals requesting access to health records in order to ensure compliance with privacy and security requirements.
To find comprehensive and official information regarding HIPAA, patient authorization, and healthcare provider responsibilities, you can use several authoritative sources. Here are the best places to access detailed information:
1. U.S. Department of Health and Human Services (HHS) - Office for Civil Rights (OCR):
The HHS is responsible for enforcing HIPAA regulations. Their website contains comprehensive information about HIPAA, including patient rights, healthcare provider responsibilities, and guidelines for the release of medical records. Specific sections to explore:
a) HIPAA for Individuals: Provides information on patients' rights to access their health information.
b) HIPAA for Professionals: This section includes detailed information for healthcare providers, including privacy and security rules, breach notification rules, and compliance tips.
c) FAQs on HIPAA: The HHS website offers a section with frequently asked questions (FAQs) about HIPAA, which might address specific queries you have about medical record release processes.
2. The Federal Register:
The Federal Register publishes the full text of federal regulations, including HIPAA. It provides legal background and amendments to HIPAA over time. You can access the original HIPAA regulations and amendments.
-Website: HIPAA Home | HHS.gov
3. The American Medical Association (AMA):
The AMA provides guidance to healthcare providers on HIPAA compliance, patient rights, and proper medical record handling. They have a section dedicated to privacy and security rules that apply to healthcare professionals.
4. The National Institutes of Health (NIH) - National Library of Medicine:
The NIH offers an excellent resource for healthcare providers to understand HIPAA and privacy rules, particularly how to handle patient information ethically and legally.
5. State Medical Boards:
In addition to federal HIPAA regulations, state laws may also apply to patient information release and identity verification. You can consult your local or state medical board’s website for specific requirements in your region.
You can locate your state’s medical board through the Federation of State Medical Boards: FSMB - State Medical Boards.
General Form for Patients
Authorization to a Third Party