HIPAA Authorization Form Template

Every patient needs an annual HIPAA Authorization Form on file to protect health information and adhere to the law. Collect signed forms easily by sending and receiving them electronically. Patients can complete or update this form anytime, anywhere with a phone, tablet, or computer.
hipaa-authorization-form

HIPAA Authorization Form Template

Give your patients the freedom to complete HIPAA authorization forms with any device, anywhere. Streamline the way you collect required signatures and complete patient files by setting up your form online.

Easily personalize this form template with a HIPAA compliant form builder.

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What is the HIPAA Authorization Form?

Each patient is authorized to designate who the clinic can disclose health information to, as well as what exact information can be shared. The patient also needs to understand his/her rights under HIPAA laws. This form accomplishes all of that in one easy-to-update and customize form.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge.

The liability falls on you to handle patient data in a compliant way. Patient privacy is a serious topic, legislation from the Health Insurance Portability and Accountability Act to the Patient Protection and Affordable Care Act place heavy fines on medical professionals who mistreat patient information.

A medical release form does not empower your staff to share patient information with just anyone. Depending on what is included in the form, the document may release medical information to the patient’s family, other doctors, insurance providers, attorneys, or anyone who may make healthcare decisions on behalf of the patient.

Discover More Form Features

Setup HIPAA compliant online forms. Streamline your process of collecting information from patients.
Required HIPAA Compliant Form Fields

Required Form Fields

Always get the information you need with required fields. Patients can only submit when they complete all of your required fields. Never receive an incomplete medical form again.

Mobile Friendly Forms

Mobile-Friendly Forms

Easily build fully-responsive medical forms online that allow your patients to sign and submit on any device, anywhere, at any time.

HIPAA Compliant Submission Audit Logs

Submission Audit Logs

Form submissions have a detailed history that can always be referenced. Audit logs cannot be changed and the history from all users is tracked.

Custom Thank You Page

Custom Thank You Page

Create your own custom ‘Thank You’ page to direct patients to upon completion of your forms. Forward them along to the next steps of your intake process.

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  • Not having an online custom form to offer patients was a huge struggle. FormDr makes paperwork seamless and saves a ton of time and money by allowing us to upload to patients EMR rather than print, fill out, scan, and then attach. That is now a hindrance of the PAST!

    Woodlands Dermatology
    Angela H.
  • Patients can fill out the forms at their leisure, and don’t have to print anything. We’re collecting more completed forms than ever, and patients love not having to do anything when they come to the office for the first time.

    FYZICAL MetroWest
    Lauren A.
  • FormDr allows me to send and receive attractive, professional forms from patients. Very helpful that I can remind patients of their appointment time and check the status of the form.

    Banks Hepatology Institute PC
    Alpha B.
  • Sending a PDF was too time consuming for the patients to do, and it required the additional steps of printing and scanning it into our own systems. FormDr made it easier to get patients to complete the forms by email, and it’s a more secure way to provide info than simply emailing back a completed PDF.

    Reload Therapy
    Angie I.
  • Before FormDr, the most common struggle were our patients taking a long time to complete forms in our office. Now patients are able to be seen faster when forms are completed prior to visit. Very easy service to create forms online!

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    Courtney M.
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  • Before, clients weren’t signing our forms before the appointment. FormDr has allowed us to share our documents for client review and signatures. I really appreciate the support, it has been super helpful simplifying our forms!

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FormDr gives your practice everything needed to easily send and receive HIPAA compliant forms online. We help practices who:

  • Are having patients fill out paper forms during the appointment
  • Are emailing patients a PDF or Word Doc to print out, fill out, scan, and send back
  • Are spending time manually printing and scanning paper forms