Learn About HIPAA Forms


One of the main purposes of the Health Insurance Portability and Accountability Act (HIPAA) is to insure an individual’s rights and privacy by protecting the confidentiality of their medical records. One of the procedures that HIPAA has established to accomplish this is to delineate the means in which protected health information may be released. Specific information and questions must be completed by the patient on an Authorization form in order to give another party permission to access to their protected health information.

The form to be used for the release of information must advise the patient of their rights, state the information they are agreeing to release and to whom it may be released. It must also contain a statement making the patient aware of the possibility of the records being re-released at a later time to parties not specifically named to receive them. The form must also contain an expiration time frame. MLR’s authorization form is fully HIPAA compliant and is available on this website in PDF format for your convenience.

How HIPAA Affects the Production of Documents

The issuance of a Subpoena to secure documents and things is still governed by the rules of the presiding Court. Authorizations are not needed in combination with a Subpoena unless the documents contain reference to treatment for drugs, alcohol, mental health or HIV. HIPAA does state that the custodian of documents, when in receipt of a subpoena, must obtain confirmation that the patient, either directly or indirectly through their counsel, was notified of the issuance of the subpoena, given enough time to object and that no objection was raised. MLR sends confirmation of these facts along with all subpoenas. If a custodian requires an affidavit stating these facts, MLR will execute and return the affidavit attesting to our notification of counsel.

Our Customer Service Department will keep you informed on the progress of your request. If an Authorization is necessary in addition to the issued Subpoena we will send for one on your behalf. We will forward our HIPAA-compliant form directly to Plaintiff’s counsel for signature by the patient.

HIPAA Authorization Forms

HIPAA Authorizations for the release of information are available for your review and use and can be accessed via the HIPAA Forms link at the top of the page or by clicking here.