HIPAA Authorization Form For Family MembersAI Template IconToolbar IconShare Icon

HIPAA Authorization Form For Family Members

Understand how a HIPAA Authorization Form For Family Members works. Download a free template and example to help patients protect their information.

Ericka Pingol avatar

By Ericka Pingol on Aug 2, 2025.

Fact Checked by Ericka Pingol.

Use Template

HIPAA Authorization Form For Family Members Template

Download PDF Template

Commonly asked questions

HIPAA requires individuals to provide explicit written authorization before their protected health information (PHI) can be shared with family members, healthcare providers, or insurance companies.

Family members must adhere to HIPAA regulations when they are authorized to access an individual's PHI, ensuring they do not disclose the information without proper consent.

Yes, California has additional privacy laws, like the Confidentiality of Medical Information Act (CMIA), which provide stricter protections than federal HIPAA regulations, requiring explicit written consent for sharing PHI.

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