[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"page-\u002Fcategories\u002Fpersonal-affairs\u002Fhipaa-authorization":3},{"type":4,"data":5},"product",{"product_name":6,"slug":7,"category_slug":8,"order_type":9,"product_version_slug":10,"preview":11,"is_previewable":12,"related_products":13,"related_articles":30,"breadcrumbs":63,"productName":6,"productDescription":-1,"productVersionSlug":10,"localeId":-1,"landerSlug":7,"categorySlug":8,"_cmsSource":69,"hero":70,"quickLinks":96,"page_body":97,"meta_information":527,"sidebar_ad":531,"disclaimer":103,"stateSlug":73},"HIPAA Authorization","hipaa-authorization","healthcare","Document","hipaa-001","&lt;center&gt;&lt;p class=&#39;title center&#39;&gt;&lt;strong&gt;ALABAMA HIPAA AUTHORIZATION FOR USE OR DISCLOSURE OF PROTECTED HEALTH INFORMATION&lt;\u002Fstrong&gt;&lt;\u002Fp&gt;&lt;\u002Fcenter&gt;&lt;br \u002F&gt;&lt;br \u002F&gt;&lt;p&gt;This form authorizes the use or disclosure of protected health information (PHI) about &lt;span style=&#39;background: #BBBBBB;&#39;&gt;_____________&lt;\u002Fspan&gt;. It is built to satisfy the federal HIPAA Privacy Rule.&lt;\u002Fp&gt;&lt;p&gt;&lt;b&gt;SECTION 1. THE INDIVIDUAL&lt;\u002Fb&gt;&lt;\u002Fp&gt;&lt;p&gt;Name of Patient: &lt;span style=&#39;background: #BBBBBB;&#39;&gt;_____________&lt;\u002Fspan&gt;&lt;\u002Fp&gt;&lt;p&gt;Date of Birth: &lt;span style=&#39;background: #BBBBBB;&#39;&gt;_____________&lt;\u002Fspan&gt;&lt;\u002Fp&gt;&lt;p&gt;Address: &lt;span style=&#39;background: #BBBBBB;&#39;&gt;_____________&lt;\u002Fspan&gt;, &lt;span style=&#39;background: #BBBBBB;&#39;&gt;_____________&lt;\u002Fspan&gt;, &lt;span style=&#39;background: #BBBBBB;&#39;&gt;_____________&lt;\u002Fspan&gt; &lt;span style=&#39;background: #BBBBBB;&#39;&gt;_____________&lt;\u002Fspan&gt;&lt;\u002Fp&gt;&lt;p&gt;&lt;b&gt;SECTION 2. AUTHORIZATION&lt;\u002Fb&gt;&lt;\u002Fp&gt;&lt;p&gt;I, the undersigned, authorize &lt;span style=&#39;background: #BBBBBB;&#39;&gt;_____________&lt;\u002Fspan&gt; to release to:&lt;\u002Fp&gt;&lt;p&gt;&lt;span style=&#39;background: #BBBBBB;&#39;&gt;_____________&lt;\u002Fspan&gt;&lt;\u002Fp&gt;&lt;p&gt;&lt;span style=&#39;background: #BBBBBB;&#39;&gt;_____________&lt;\u002Fspan&gt;, &lt;span style=&#39;background: #BBBBBB;&#39;&gt;_____________&lt;\u002Fspan&gt;, &lt;span style=&#39;background: #BBBBBB;&#39;&gt;_____________&lt;\u002Fspan&gt; &lt;span style=&#39;background: #BBBBBB;&#39;&gt;_____________&lt;\u002Fspan&gt;&lt;\u002Fp&gt;&lt;p&gt;the following information:&lt;\u002Fp&gt;&lt;p&gt;  [ ] All health information &amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;  [ ] Specific information described below&lt;\u002Fp&gt;&lt;p&gt;  [ ] Records for a specific date range &amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;  [ ] Other (described below)&lt;\u002Fp&gt;&lt;p&gt;Hereinafter the &quot;Protected Health Information&quot; or &quot;PHI.&quot; &lt;\u002Fp&gt;&lt;p&gt;&lt;b&gt;SECTION 3. SENSITIVE INFORMATION CHECKLIST&lt;\u002Fb&gt;&lt;\u002Fp&gt;&lt;p&gt;This disclosure includes the following categories of sensitive information (check all that apply):&lt;\u002Fp&gt;&lt;p&gt;  [ ] Mental Health Treatment Records &amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;  [ ] HIV\u002FAIDS-Related Information &amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;  [ ] Substance Use Disorder Records&lt;\u002Fp&gt;&lt;p&gt;  [ ] Genetic Testing Information &amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;  [ ] Psychotherapy Notes (authorized separately below)&lt;\u002Fp&gt;&lt;p&gt;I understand that the categories checked above may include, but are not limited to, history, diagnoses, and\u002For treatment of drug or alcohol abuse, mental health conditions, or communicable disease, including Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS), and genetic information.&lt;\u002Fp&gt;&lt;br&gt;&lt;p&gt;&lt;b&gt;SECTION 4. PURPOSE OF DISCLOSURE&lt;\u002Fb&gt;&lt;\u002Fp&gt;&lt;p&gt;  [ ] At the Request of the Individual &amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;  [ ] Treatment\u002FPayment\u002FHealth Care Operations&lt;\u002Fp&gt;&lt;p&gt;  [ ] Legal\u002FInsurance\u002FBenefits Eligibility &amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;  [ ] Marketing Communication&lt;\u002Fp&gt;&lt;p&gt;  [ ] Sale of Protected Health Information &amp;nbsp;&amp;nbsp;&amp;nbsp;&amp;nbsp;  [ ] Other&lt;\u002Fp&gt;&lt;p&gt;&lt;b&gt;SECTION 5. EXPIRATION&lt;\u002Fb&gt;&lt;\u002Fp&gt;  &lt;p&gt;This authorization must state an expiration date or event.&lt;\u002Fp&gt;&lt;p&gt;&lt;b&gt;SECTION 6. CONFIDENTIALITY AND REDISCLOSURE&lt;\u002Fb&gt;&lt;\u002Fp&gt;&lt;p&gt;I understand that my PHI is confidential and cannot be disclosed without my written authorization, except when otherwise permitted by law. Information used or disclosed pursuant to this authorization may be subject to redisclosure by the Recipient and may no longer be protected by the HIPAA Privacy Rule.&lt;\u002Fp&gt;&lt;p&gt;&lt;b&gt;SECTION 7. CONDITIONING&lt;\u002Fb&gt;&lt;\u002Fp&gt;&lt;p&gt;I understand that treatment, payment, enrollment, or eligibility for benefits may not be conditioned on my signing this authorization.&lt;\u002Fp&gt;&lt;p&gt;&lt;b&gt;SECTION 8. MY RIGHTS&lt;\u002Fb&gt;&lt;\u002Fp&gt;&lt;p&gt;I may refuse to sign this authorization.&lt;\u002Fp&gt;&lt;p&gt;I may inspect or obtain a copy of the health information that I am being asked to allow the use or disclosure of.&lt;\u002Fp&gt;&lt;p&gt;I may revoke this authorization at any time, but I must do so in writing and submit it to the following address: the Covered Entity&#39;s Privacy Officer. My revocation will take effect upon receipt, except to the extent that others have already acted in reliance upon this authorization, or, if this authorization was obtained as a condition of obtaining insurance coverage, to the extent other law provides the insurer the right to contest a claim under the policy.&lt;\u002Fp&gt;&lt;p&gt;I have a right to receive a copy of this authorization.&lt;\u002Fp&gt;&lt;br&gt;&lt;div class=&#39;-page-break&#39;&gt;&lt;\u002Fdiv&gt;&lt;p&gt;&lt;b&gt;SECTION 9. SIGNATURE&lt;\u002Fb&gt;&lt;\u002Fp&gt;&lt;p&gt;Date: ____________________ &lt;\u002Fp&gt;&lt;p&gt;Signature: __________________________________ &lt;i&gt;(Patient or Legally Authorized Representative)&lt;\u002Fi&gt;&lt;\u002Fp&gt;&lt;p&gt;Printed Name of Patient or Legally Authorized Representative: __________________________________&lt;\u002Fp&gt;&lt;p&gt;Relationship to Patient: __________________________________ &lt;i&gt;(Self, if signed by the Patient)&lt;\u002Fi&gt;&lt;\u002Fp&gt;&lt;p&gt;&lt;i&gt;Optional Witness (complete only if required by the Recipient or by applicable state law):&lt;\u002Fi&gt;&lt;\u002Fp&gt;&lt;p&gt;Witness Signature: __________________________________ Date: ____________________&lt;\u002Fp&gt;&lt;div class=&#39;-page-break&#39;&gt;&lt;\u002Fdiv&gt;&lt;center&gt;&lt;p class=&#39;title center&#39;&gt;&lt;strong&gt;Instructions for Your HIPAA Authorization&lt;\u002Fstrong&gt;&lt;\u002Fp&gt;&lt;\u002Fcenter&gt;&lt;br \u002F&gt;&lt;br \u002F&gt;&lt;p&gt;&lt;b&gt;Completing Your Document&lt;\u002Fb&gt;&lt;\u002Fp&gt;&lt;p&gt;This form authorizes a covered entity to use or disclose an individual&#39;s protected health information (PHI). Federal law sets a baseline that applies in every state; a small number of states — California, Florida, Maryland, Minnesota, and Rhode Island — add their own general requirements, New York and Pennsylvania each require a dedicated addendum before HIV-related information can be disclosed at all, and Texas imposes a specific revocation rule for psychotherapy notes.&lt;\u002Fp&gt;&lt;p&gt;&lt;b&gt;Psychotherapy Notes&lt;\u002Fb&gt;&lt;\u002Fp&gt;&lt;p&gt;If the disclosure includes psychotherapy notes, federal law requires those notes to be authorized in a completely separate, standalone document — it cannot be combined with the general authorization above. If you selected &quot;Yes&quot; to psychotherapy notes, this package includes both: a general authorization covering everything else you selected, followed by a standalone psychotherapy notes authorization. If the governing state is Texas, the standalone document also includes Texas&#39;s specific revocation rule for mental-health-professional records (Tex. Health &amp;amp; Safety Code Sec. 611.007).&lt;\u002Fp&gt;&lt;p&gt;&lt;b&gt;Sensitive Information (Optional)&lt;\u002Fb&gt;&lt;\u002Fp&gt;&lt;p&gt;General mental health treatment information, HIV\u002FAIDS-related information, substance use disorder treatment records, and genetic information each carry additional federal or state protection. The general authorization includes a checklist and notice covering all of these categories. If the governing state is California and the disclosure includes HIV test results, California independently requires a separate written authorization for each disclosure. A general authorization is not sufficient on its own for that category.&lt;\u002Fp&gt;&lt;p&gt;&lt;b&gt;State-Specific Requirements&lt;\u002Fb&gt;&lt;\u002Fp&gt;&lt;p&gt;If the governing state is California, Florida, Maryland, Minnesota, or Rhode Island, this document includes that state&#39;s additional required language automatically. If the governing state is New York or Pennsylvania and the disclosure includes HIV-related information, a dedicated addendum with its own signature line is included; a general authorization is not legally sufficient for that category in those two states.&lt;\u002Fp&gt;&lt;p&gt;&lt;b&gt;Expiration&lt;\u002Fb&gt;&lt;\u002Fp&gt;&lt;p&gt;If no expiration date or event is provided, California, Maryland, and Minnesota default to one year from signing. No default applies in any other state — an expiration date or event must be stated for the authorization to be valid there.&lt;\u002Fp&gt;&lt;p&gt;&lt;b&gt;Conditioning&lt;\u002Fb&gt;&lt;\u002Fp&gt;&lt;p&gt;Federal law limits when a covered entity may refuse treatment, payment, enrollment, or eligibility for benefits based on whether this authorization is signed. Review Section Conditioning above carefully; most authorizations should use the &quot;may not condition&quot; statement.&lt;\u002Fp&gt;&lt;p&gt;&lt;b&gt;NOTE: THIS IS AN IMPORTANT LEGAL DOCUMENT. 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Some states require just a physician's signature alongside the patient's; others demand two witnesses, a notary, or authorization from a designated ...","\u002Fguides\u002Fdnr-signature-requirements-by-state",{"title":60,"description":61,"link":62},"When Should a Company Change Its Principal Office Address?","As businesses evolve, grow, and adapt to changing circumstances, there may come a time when changing the principal office address becomes necessary. 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LegalNature's HIPAA authorization form is state-compliant and lets you specify exactly what information can be shared, with whom, and for how long.",{"type":116,"format":103,"indent":104,"version":105,"children":123,"direction":73,"textStyle":103,"textFormat":104},[124],{"mode":112,"text":125,"type":114,"style":103,"detail":104,"format":104,"version":105},"Most people don't think about medical records access until they're in a hospital waiting room being told a spouse or adult child \"can't be given any information\" — even in an emergency. A HIPAA authorization closes that gap before it becomes a crisis. It's a short, simple document, but it does something a general power of attorney or advance directive doesn't: it directly unlocks communication between your healthcare providers and the people you trust.","default","left","medium","rich-content",{"hideOnMobile":73,"hideOnDesktop":73},{"id":132,"heading":133,"layout":134,"columns":73,"itemStyle":135,"blockName":73,"items":136,"blockType":174,"visibility":175},"6a8dea395cb0a7cbbec42641","See our other healthcare documents","grid","card-with-image",[137,154],{"id":138,"title":19,"description":139,"legacyHtml":73,"image":146,"imageUrl":73,"url":153},"6a8dea495cb0a7cbbec42642",{"root":140},{"type":102,"format":103,"indent":104,"version":105,"children":141,"direction":73},[142],{"type":116,"format":103,"indent":104,"version":105,"children":143,"direction":73,"textStyle":103,"textFormat":104},[144],{"mode":112,"text":145,"type":114,"style":103,"detail":104,"format":104,"version":105},"Authorizes a trusted person to make medical decisions if you are unable to communicate your wishes, including end-of-life care and treatment choices. Also referred to as a medical power of attorney in many states.",{"id":147,"alt":73,"updatedAt":148,"createdAt":149,"url":150,"thumbnailURL":73,"filename":151,"mimeType":81,"filesize":152,"width":83,"height":84,"focalX":85,"focalY":85},360,"2026-09-15T11:43:12.674Z","2026-09-15T11:43:12.565Z","https:\u002F\u002Fs3.us-east-2.amazonaws.com\u002Fshared-cms-main-media.legalnature.com\u002FHPOA%20preview.png","HPOA preview.png",1088874,"\u002Fdocuments\u002Fcreate\u002Fhealthcare-power-of-attorney",{"id":155,"title":28,"description":156,"legacyHtml":73,"image":163,"imageUrl":103,"url":173},"6a8dea585cb0a7cbbec42643",{"root":157},{"type":102,"format":103,"indent":104,"version":105,"children":158,"direction":73},[159],{"type":116,"format":103,"indent":104,"version":105,"children":160,"direction":73,"textStyle":103,"textFormat":104},[161],{"mode":112,"text":162,"type":114,"style":103,"detail":104,"format":104,"version":105},"A legal document that lets a person outline their preferences for medical care if they become unable to make or communicate their own decisions due to illness or incapacity.",{"id":164,"alt":73,"updatedAt":165,"createdAt":166,"url":167,"thumbnailURL":73,"filename":168,"mimeType":169,"filesize":170,"width":171,"height":172,"focalX":85,"focalY":85},241,"2026-10-14T16:33:47.088Z","2026-08-05T20:43:15.110Z","https:\u002F\u002Fs3.us-east-2.amazonaws.com\u002Fshared-cms-main-media.legalnature.com\u002FAdvance%20Healthcare%20Directive%20Preview%20D","Advance Healthcare Directive Preview D","image\u002Fwebp",442816,1200,1448,"\u002Fdocuments\u002Fcreate\u002Fadvance-healthcare-directive","list",{"hideOnMobile":73,"hideOnDesktop":73},{"id":177,"heading":178,"showStates":12,"hideOnStateOverride":179,"blockName":73,"blockType":180,"visibility":181},"6a8deb3c5cb0a7cbbec42644","Create a HIPAA authorization in your 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document",{"root":200},{"type":102,"format":103,"indent":104,"version":105,"children":201,"direction":73},[202],{"type":116,"format":103,"indent":104,"version":105,"children":203,"direction":73,"textStyle":103,"textFormat":104},[204],{"mode":112,"text":205,"type":114,"style":103,"detail":104,"format":104,"version":105},"Review your state-specific HIPAA authorization before finalizing it.",{"id":207,"title":208,"description":209,"legacyHtml":73},"6a8dec375cb0a7cbbec4264b","Print, sign, and deliver",{"root":210},{"type":102,"format":103,"indent":104,"version":105,"children":211,"direction":73},[212],{"type":116,"format":103,"indent":104,"version":105,"children":213,"direction":73,"textStyle":103,"textFormat":104},[214],{"mode":112,"text":215,"type":114,"style":103,"detail":104,"format":104,"version":105},"Print and sign your authorization, then provide a copy to each healthcare provider, hospital, or health plan you want to honor it.","steps",{"hideOnMobile":73,"hideOnDesktop":73},{"id":219,"content":220,"legacyHtml":73,"variant":126,"anchorId":73,"alignment":127,"ctaText":287,"ctaLink":288,"padding":128,"blockName":73,"blockType":129,"visibility":289},"6a8deb685cb0a7cbbec42645",{"root":221},{"type":102,"format":103,"indent":104,"version":105,"children":222,"direction":73},[223,227],{"tag":108,"type":109,"format":103,"indent":104,"version":105,"children":224,"direction":73},[225],{"mode":112,"text":226,"type":114,"style":103,"detail":104,"format":104,"version":105},"Why you may need a HIPAA authorization",{"tag":228,"type":174,"start":105,"format":103,"indent":104,"version":105,"children":229,"listType":286,"direction":73,"textFormat":105},"ul",[230,237,244,251,258,265,272,279],{"type":231,"value":105,"format":103,"indent":104,"version":105,"children":232,"direction":73},"listitem",[233,235],{"mode":112,"text":234,"type":114,"style":103,"detail":104,"format":105,"version":105},"Give a spouse or adult child access to your medical records",{"mode":112,"text":236,"type":114,"style":103,"detail":104,"format":104,"version":105}," so they can follow up with doctors, review test results, or manage care during a hospitalization.",{"type":231,"value":238,"format":103,"indent":104,"version":105,"children":239,"direction":73},2,[240,242],{"mode":112,"text":241,"type":114,"style":103,"detail":104,"format":105,"version":105},"Let a caregiver coordinate care",{"mode":112,"text":243,"type":114,"style":103,"detail":104,"format":104,"version":105}," across multiple providers without waiting on you to personally approve every call.",{"type":231,"value":245,"format":103,"indent":104,"version":105,"children":246,"direction":73},3,[247,249],{"mode":112,"text":248,"type":114,"style":103,"detail":104,"format":105,"version":105},"Keep family members informed during travel, surgery, or illness",{"mode":112,"text":250,"type":114,"style":103,"detail":104,"format":104,"version":105}," without them having to track you down for verbal permission each time.",{"type":231,"value":252,"format":103,"indent":104,"version":105,"children":253,"direction":73},4,[254,256],{"mode":112,"text":255,"type":114,"style":103,"detail":104,"format":105,"version":105},"Support an aging parent's care",{"mode":112,"text":257,"type":114,"style":103,"detail":104,"format":104,"version":105}," by giving one or more adult children the ability to speak directly with physicians and hospital staff.",{"type":231,"value":259,"format":103,"indent":104,"version":105,"children":260,"direction":73},5,[261,263],{"mode":112,"text":262,"type":114,"style":103,"detail":104,"format":105,"version":105},"Protect against gaps left by other estate planning documents",{"mode":112,"text":264,"type":114,"style":103,"detail":104,"format":104,"version":105}," — a healthcare power of attorney authorizes someone to make medical decisions, but it doesn't always guarantee the same person can access records unless HIPAA-compliant language is included.",{"type":231,"value":266,"format":103,"indent":104,"version":105,"children":267,"direction":73},6,[268,270],{"mode":112,"text":269,"type":114,"style":103,"detail":104,"format":105,"version":105},"Control disclosure instead of leaving it to chance",{"mode":112,"text":271,"type":114,"style":103,"detail":104,"format":104,"version":105}," by naming exactly who can receive your information and what categories of records they can see.",{"type":231,"value":273,"format":103,"indent":104,"version":105,"children":274,"direction":73},7,[275,277],{"mode":112,"text":276,"type":114,"style":103,"detail":104,"format":105,"version":105},"Simplify insurance and billing questions",{"mode":112,"text":278,"type":114,"style":103,"detail":104,"format":104,"version":105}," by authorizing a trusted person to discuss claims, coverage, or billing disputes with your health plan.",{"type":231,"value":280,"format":103,"indent":104,"version":105,"children":281,"direction":73},8,[282,284],{"mode":112,"text":283,"type":114,"style":103,"detail":104,"format":105,"version":105},"Set an expiration date or event",{"mode":112,"text":285,"type":114,"style":103,"detail":104,"format":104,"version":105}," so the authorization doesn't outlive its purpose.","bullet","Create Your HIPAA Authorization 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cover",{"type":116,"format":103,"indent":104,"version":105,"children":306,"direction":73,"textStyle":103,"textFormat":105},[307,309],{"mode":112,"text":308,"type":114,"style":103,"detail":104,"format":105,"version":105},"A HIPAA authorization can be as broad or as narrow as you want it to be.",{"mode":112,"text":310,"type":114,"style":103,"detail":104,"format":104,"version":105}," You choose the categories of information covered, and your document should specifically identify each one rather than relying on a blanket \"all records\" statement, which some providers will not accept. Common categories include the following:",{"tag":228,"type":174,"start":105,"format":103,"indent":104,"version":105,"children":312,"listType":286,"direction":73},[313,317,321,325,329],{"type":231,"value":105,"format":103,"indent":104,"version":105,"children":314,"direction":73},[315],{"mode":112,"text":316,"type":114,"style":103,"detail":104,"format":104,"version":105},"General medical records, including diagnoses, treatment notes, and physician correspondence",{"type":231,"value":238,"format":103,"indent":104,"version":105,"children":318,"direction":73},[319],{"mode":112,"text":320,"type":114,"style":103,"detail":104,"format":104,"version":105},"Billing, insurance, and payment records",{"type":231,"value":245,"format":103,"indent":104,"version":105,"children":322,"direction":73},[323],{"mode":112,"text":324,"type":114,"style":103,"detail":104,"format":104,"version":105},"Hospital and emergency room records",{"type":231,"value":252,"format":103,"indent":104,"version":105,"children":326,"direction":73},[327],{"mode":112,"text":328,"type":114,"style":103,"detail":104,"format":104,"version":105},"Prescription and pharmacy records",{"type":231,"value":259,"format":103,"indent":104,"version":105,"children":330,"direction":73},[331],{"mode":112,"text":332,"type":114,"style":103,"detail":104,"format":104,"version":105},"Lab results and diagnostic imaging",{"hideOnMobile":73,"hideOnDesktop":73},{"id":335,"content":336,"legacyHtml":73,"variant":365,"anchorId":73,"alignment":127,"ctaText":287,"ctaLink":73,"padding":128,"blockName":73,"blockType":129,"visibility":366},"6a8deb9a5cb0a7cbbec42647",{"root":337},{"type":102,"format":103,"indent":104,"version":105,"children":338,"direction":73},[339,343,361],{"type":116,"format":103,"indent":104,"version":105,"children":340,"direction":73,"textStyle":103,"textFormat":105},[341],{"mode":112,"text":342,"type":114,"style":103,"detail":104,"format":105,"version":105},"Certain categories of health information carry extra legal protection and may need to be specifically called out in your authorization, or may require a separate authorization entirely depending on the provider and state:",{"tag":228,"type":174,"start":105,"format":103,"indent":104,"version":105,"children":344,"listType":286,"direction":73},[345,349,353,357],{"type":231,"value":105,"format":103,"indent":104,"version":105,"children":346,"direction":73},[347],{"mode":112,"text":348,"type":114,"style":103,"detail":104,"format":104,"version":105},"Mental health and psychotherapy notes",{"type":231,"value":238,"format":103,"indent":104,"version":105,"children":350,"direction":73},[351],{"mode":112,"text":352,"type":114,"style":103,"detail":104,"format":104,"version":105},"HIV\u002FAIDS status and other communicable disease information",{"type":231,"value":245,"format":103,"indent":104,"version":105,"children":354,"direction":73},[355],{"mode":112,"text":356,"type":114,"style":103,"detail":104,"format":104,"version":105},"Substance use disorder treatment records, which are independently protected under a federal regulation known as 42 C.F.R. Part 2",{"type":231,"value":252,"format":103,"indent":104,"version":105,"children":358,"direction":73},[359],{"mode":112,"text":360,"type":114,"style":103,"detail":104,"format":104,"version":105},"Genetic testing information",{"type":116,"format":103,"indent":104,"version":105,"children":362,"direction":73,"textStyle":103,"textFormat":104},[363],{"mode":112,"text":364,"type":114,"style":103,"detail":104,"format":104,"version":105},"If you want a specific person to have access to any of these sensitive categories, say so explicitly in the authorization. A general authorization that doesn't name these categories may not be enough for a provider to release them, and consulting with an attorney is recommended if your situation involves highly sensitive medical information.","highlight",{"hideOnMobile":73,"hideOnDesktop":73},{"id":368,"style":292,"size":369,"blockName":73,"blockType":294,"visibility":370},"6a8dee6d5cb0a7cbbec42659","md",{"hideOnMobile":73,"hideOnDesktop":73},{"id":372,"content":373,"legacyHtml":73,"variant":126,"anchorId":73,"alignment":127,"ctaText":412,"ctaLink":413,"padding":128,"blockName":73,"blockType":129,"visibility":414},"6a8dee635cb0a7cbbec42658",{"root":374},{"type":102,"format":103,"indent":104,"version":105,"children":375,"direction":73},[376,380,384,406],{"tag":108,"type":109,"format":103,"indent":104,"version":105,"children":377,"direction":73},[378],{"mode":112,"text":379,"type":114,"style":103,"detail":104,"format":104,"version":105},"HIPAA Authorization vs. Healthcare Power of Attorney",{"type":116,"format":103,"indent":104,"version":105,"children":381,"direction":73,"textStyle":103,"textFormat":104},[382],{"mode":112,"text":383,"type":114,"style":103,"detail":104,"format":104,"version":105},"These two documents are often confused, but they serve different purposes and are not substitutes for each other:",{"tag":228,"type":174,"start":105,"format":103,"indent":104,"version":105,"children":385,"listType":286,"direction":73},[386,396],{"type":231,"value":105,"format":103,"indent":104,"version":105,"children":387,"direction":73},[388,390,392,394],{"mode":112,"text":389,"type":114,"style":103,"detail":104,"format":105,"version":105},"HIPAA authorization",{"mode":112,"text":391,"type":114,"style":103,"detail":104,"format":104,"version":105}," — Gives a named person permission to ",{"mode":112,"text":393,"type":114,"style":103,"detail":104,"format":238,"version":105},"receive information",{"mode":112,"text":395,"type":114,"style":103,"detail":104,"format":104,"version":105}," about your medical records and health status. It does not give that person authority to make decisions on your behalf.",{"type":231,"value":238,"format":103,"indent":104,"version":105,"children":397,"direction":73},[398,400,402,404],{"mode":112,"text":399,"type":114,"style":103,"detail":104,"format":105,"version":105},"Healthcare power of attorney",{"mode":112,"text":401,"type":114,"style":103,"detail":104,"format":104,"version":105}," — Gives your agent authority to ",{"mode":112,"text":403,"type":114,"style":103,"detail":104,"format":238,"version":105},"make medical decisions",{"mode":112,"text":405,"type":114,"style":103,"detail":104,"format":104,"version":105}," for you if you become unable to make them yourself. It does not automatically guarantee your agent access to your records unless the document also includes HIPAA-compliant authorization language.",{"type":116,"format":103,"indent":104,"version":105,"children":407,"direction":73,"textStyle":103,"textFormat":105},[408,410],{"mode":112,"text":409,"type":114,"style":103,"detail":104,"format":105,"version":105},"The safest approach is to have both.",{"mode":112,"text":411,"type":114,"style":103,"detail":104,"format":104,"version":105}," A healthcare power of attorney without HIPAA authorization language can leave your agent unable to get the information they need to make informed decisions. A HIPAA authorization without a healthcare power of attorney lets someone see your records, but it doesn't give them any decision-making authority if you're incapacitated.","Learn More About a Healthcare Power of Attorney","https:\u002F\u002Fwww.legalnature.com\u002Fcategories\u002Fhealthcare\u002Fhealthcare-power-of-attorney",{"hideOnMobile":73,"hideOnDesktop":73},{"id":416,"style":292,"size":369,"blockName":73,"blockType":294,"visibility":417},"6a8deea05cb0a7cbbec4265a",{"hideOnMobile":73,"hideOnDesktop":73},{"id":419,"heading":420,"description":421,"legacyHtml":73,"image":428,"imageUrl":103,"layout":437,"blockName":73,"blockType":438,"visibility":439},"6a8deda85cb0a7cbbec4264e","Why choose LegalNature?",{"root":422},{"type":102,"format":103,"indent":104,"version":105,"children":423,"direction":73},[424],{"type":116,"format":103,"indent":104,"version":105,"children":425,"direction":73,"textStyle":103,"textFormat":104},[426],{"mode":112,"text":427,"type":114,"style":103,"detail":104,"format":104,"version":105},"LegalNature offers the guidance to navigate the nuances of healthcare document creation across all 50 states and the District of Columbia. LegalNature offers a 30-day money-back guarantee. If you're not happy, then we’re not happy. Give us a call and let us help.",{"id":429,"alt":73,"updatedAt":430,"createdAt":431,"url":432,"thumbnailURL":73,"filename":433,"mimeType":169,"filesize":434,"width":435,"height":436,"focalX":85,"focalY":85},218,"2026-07-29T18:21:40.238Z","2026-07-29T18:21:40.153Z","https:\u002F\u002Fs3.us-east-2.amazonaws.com\u002Fshared-cms-main-media.legalnature.com\u002FWhy%20Choose","Why Choose",204042,786,958,"image-right","media-content",{"hideOnMobile":73,"hideOnDesktop":73},{"id":441,"style":292,"size":369,"blockName":73,"blockType":294,"visibility":442},"6a8dedcf5cb0a7cbbec4264f",{"hideOnMobile":73,"hideOnDesktop":73},{"id":444,"heading":445,"background":446,"blockName":73,"items":447,"blockType":518,"visibility":519},"6a8dedd65cb0a7cbbec42650","Frequently asked questions","white",[448,458,468,478,488,498,508],{"id":449,"question":450,"answer":451,"legacyHtml":73},"6a8dedde5cb0a7cbbec42651","What is a HIPAA authorization?",{"root":452},{"type":102,"format":103,"indent":104,"version":105,"children":453,"direction":73},[454],{"type":116,"format":103,"indent":104,"version":105,"children":455,"direction":73,"textStyle":103,"textFormat":104},[456],{"mode":112,"text":457,"type":114,"style":103,"detail":104,"format":104,"version":105},"A HIPAA authorization is a signed document that gives a healthcare provider, hospital, or health plan permission to share your protected health information with a person or organization you name. Without it, HIPAA's Privacy Rule generally prevents these disclosures, even to close family members.",{"id":459,"question":460,"answer":461,"legacyHtml":73},"6a8dede95cb0a7cbbec42652","Why do I need a HIPAA authorization if I already have a healthcare power of attorney?",{"root":462},{"type":102,"format":103,"indent":104,"version":105,"children":463,"direction":73},[464],{"type":116,"format":103,"indent":104,"version":105,"children":465,"direction":73,"textStyle":103,"textFormat":104},[466],{"mode":112,"text":467,"type":114,"style":103,"detail":104,"format":104,"version":105},"A healthcare power of attorney gives your agent authority to make medical decisions for you, but it doesn't always guarantee that agent — or anyone else you trust — can access your medical records. A HIPAA authorization specifically unlocks records access, so pairing the two documents closes the gap between decision-making authority and information access.",{"id":469,"question":470,"answer":471,"legacyHtml":73},"6a8dedf35cb0a7cbbec42653","What information can a HIPAA authorization release?",{"root":472},{"type":102,"format":103,"indent":104,"version":105,"children":473,"direction":73},[474],{"type":116,"format":103,"indent":104,"version":105,"children":475,"direction":73,"textStyle":103,"textFormat":104},[476],{"mode":112,"text":477,"type":114,"style":103,"detail":104,"format":104,"version":105},"You choose. A HIPAA authorization can cover general medical records, billing and insurance information, hospital records, and prescription history. Sensitive categories like mental health notes, HIV\u002Fcommunicable disease status, substance use treatment records, and genetic information typically need to be specifically named to be included.",{"id":479,"question":480,"answer":481,"legacyHtml":73},"6a8dedfd5cb0a7cbbec42654","How long does a HIPAA authorization last?",{"root":482},{"type":102,"format":103,"indent":104,"version":105,"children":483,"direction":73},[484],{"type":116,"format":103,"indent":104,"version":105,"children":485,"direction":73,"textStyle":103,"textFormat":104},[486],{"mode":112,"text":487,"type":114,"style":103,"detail":104,"format":104,"version":105},"A HIPAA authorization must include an expiration date or a specific expiration event, such as \"upon revocation\" or the end of a particular course of treatment. You choose the time frame when you create your document, and some states impose their own default limits on certain categories of sensitive information.",{"id":489,"question":490,"answer":491,"legacyHtml":73},"6a8dee075cb0a7cbbec42655","Can I revoke a HIPAA authorization?",{"root":492},{"type":102,"format":103,"indent":104,"version":105,"children":493,"direction":73},[494],{"type":116,"format":103,"indent":104,"version":105,"children":495,"direction":73,"textStyle":103,"textFormat":104},[496],{"mode":112,"text":497,"type":114,"style":103,"detail":104,"format":104,"version":105},"Yes. You can revoke a HIPAA authorization in writing at any time, except to the extent a provider has already relied on it. Once revoked, notify each provider or organization that received a copy so they update their records accordingly.",{"id":499,"question":500,"answer":501,"legacyHtml":73},"6a8dee105cb0a7cbbec42656","Do I need a HIPAA authorization for my child?",{"root":502},{"type":102,"format":103,"indent":104,"version":105,"children":503,"direction":73},[504],{"type":116,"format":103,"indent":104,"version":105,"children":505,"direction":73,"textStyle":103,"textFormat":104},[506],{"mode":112,"text":507,"type":114,"style":103,"detail":104,"format":104,"version":105},"Parents generally have access to a minor child's medical records as the child's personal representative, but this changes once a child turns 18, and it can also change earlier for certain categories of care a minor is legally allowed to consent to on their own, depending on state law. A HIPAA authorization can formalize continued access where appropriate.",{"id":509,"question":510,"answer":511,"legacyHtml":73},"6a8dee1b5cb0a7cbbec42657","Is a HIPAA authorization the same as a general medical records release?",{"root":512},{"type":102,"format":103,"indent":104,"version":105,"children":513,"direction":73},[514],{"type":116,"format":103,"indent":104,"version":105,"children":515,"direction":73,"textStyle":103,"textFormat":104},[516],{"mode":112,"text":517,"type":114,"style":103,"detail":104,"format":104,"version":105},"They serve a similar purpose, but a HIPAA authorization is specifically structured to meet the requirements of the federal HIPAA Privacy Rule, including required elements like an expiration date, a description of the information covered, and a revocation notice. A generic \"release\" form may not include everything a provider needs to honor the request.","faqs",{"hideOnMobile":73,"hideOnDesktop":73},{"id":521,"headline":522,"text":523,"image":524,"ctaText":73,"blockName":73,"blockType":525,"visibility":526},"6a8def245cb0a7cbbec4265b","Start Your HIPAA Authorization","Complete your HIPAA authorization in minutes with LegalNature's intuitive, step-by-step guidance",{"id":76,"alt":73,"updatedAt":77,"createdAt":78,"url":79,"thumbnailURL":73,"filename":80,"mimeType":81,"filesize":82,"width":83,"height":84,"focalX":85,"focalY":85},"get-started",{"hideOnMobile":73,"hideOnDesktop":73},{"title":528,"description":529,"keyword":103,"og_image":530},"HIPAA Authorization Form | LegalNature","Create a HIPAA authorization form online to let doctors, hospitals, and insurers share your medical records with the people you choose. 30-day money-back guarantee.","https:\u002F\u002Fs3.us-east-2.amazonaws.com\u002Fshared-cms-main-media.legalnature.com\u002FHIPAA%20Authorization%20Form%20thumb.jpg",{"headline":532,"image":533,"imageUrl":73,"steps":534},"Create your HIPAA authorization in minutes",{"id":87,"alt":73,"updatedAt":88,"createdAt":89,"url":90,"thumbnailURL":73,"filename":91,"mimeType":81,"filesize":92,"width":93,"height":94,"focalX":85,"focalY":85},[535,538,541],{"id":536,"text":537},"6a8defca5cb0a7cbbec4265c","Complete our form",{"id":539,"text":540},"6a8defd25cb0a7cbbec4265d","Preview and download your document",{"id":542,"text":543},"6a8defdb5cb0a7cbbec4265e","Review, sign, and deliver your document"]