HIPAA Release Form for New York

Any healthcare provider or professional in New York 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.

Yes. The patient has the right to revoke the access permissions they gave at any given time. Some forms have revocation clauses. Some professionals and providers have a separate form for this. Do note that once it has been revoked, formerly authorized individuals will no longer have access to the patient’s medical information.

That depends on what the patient wants. They can set the validity period to one month if they want, or they can specify that it is valid until they revoke it.