HIPAA Authorization FormAI Template IconToolbar IconShare Icon

HIPAA Authorization Form

Learn about HIPAA Authorization Forms and download a free sample to use when requesting access to protected health information.

Ericka Pingol avatar

By Ericka Pingol on Aug 2, 2025.

Fact Checked by Ericka Pingol.

Use Template

HIPAA Authorization Form Template

Download PDF Template

Commonly asked questions

HIPAA Authorization Forms are used by healthcare organizations, medical practices, and other entities that must comply with the HIPAA regulations.

You can use a HIPAA Authorization Form whenever patient information needs to be disclosed for a non-treatment reason. Examples include clinical trials, third-party payment requests, and research studies.

Completed HIPAA Authorization Forms should be stored securely. The best practice is to store them in an encrypted, password-protected electronic format. It's important to track who can access the forms and ensure only authorized personnel have access.

EHR and practice management software

Get started for free

*No credit card required

Free

$0/usd

Unlimited clients

Telehealth

1GB of storage

Client portal text

Automated billing and online payments