FREEBIE: Authorization for Release of Health Information

This is an template of a generic HIPAA form that a young adult can complete before enrolling in college. By filling this out, the young adult hopes that any provider will accept and honor this signed release. Although some people may accept it, it’s important to anticipate that it will be met with resistance. Most clinical practices, including any office on a college campus, will go the extra mile to have the student additionally sign a release on their own letterhead forms. It’s redundant, and it’s also how most places will cover their ass. It’s still nice to have this signed and available to share.

If you download and use this release, but you aren’t finding luck getting anyone on-campus to speak with you about your child’s health, schedule a time to talk with me. I might be able to give you some suggestions.

xx

Joanna