HIPAA Release Form for Virginia

Any healthcare provider or professional in Virginia can and should use this form for work and legal compliance. Patients can also use this to indicate who else can access their medical information, file for an insurance claim, or to use it as evidence in legal proceedings.

Patients have the right to revoke whatever authorization they have allowed before. They can revoke this authorization at any time. Once revoked, those they gave access permissions to will no longer be able to access the patient’s medical information.

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The patient or their representative will decide how long the validity of the authorization they gave will last. It can be as long as a week, or they can make the form valid for as long as they haven’t revoked it.