Authorization for Release of Medical Records Student Health Center 2016-2026

Understanding the Authorization for Release of Medical Records

The Authorization for Release of Medical Records at the student health center at the University of Tennessee, Knoxville (UTK) is a crucial document that allows students to share their medical information with designated individuals or organizations. This form is essential for students who need to transfer their medical records to another healthcare provider, insurance company, or for personal use. It ensures that the student's privacy is respected while allowing for necessary information sharing.

Steps to Complete the Authorization for Release of Medical Records

Completing the Authorization for Release of Medical Records involves several straightforward steps:

• Obtain the form from the student health center or its official website.
• Fill in personal information, including your name, date of birth, and student identification number.
• Specify the recipient of the medical records, including their name and contact information.
• Indicate the specific records you wish to release, such as immunization records, treatment history, or other relevant health information.
• Sign and date the form to confirm your consent.

After completing the form, submit it according to the instructions provided, either online, by mail, or in person at the student health center.

Legal Use of the Authorization for Release of Medical Records

The Authorization for Release of Medical Records is governed by federal and state laws, including the Health Insurance Portability and Accountability Act (HIPAA). This legislation protects the privacy of an individual's health information and outlines the conditions under which medical records can be shared. Students should ensure that they understand their rights regarding their medical information and the implications of signing the authorization.

Key Elements of the Authorization for Release of Medical Records

Several key elements must be included in the Authorization for Release of Medical Records to ensure its validity:

• Patient Information: Full name, date of birth, and contact details.
• Recipient Information: Name and address of the individual or organization receiving the records.
• Specific Records: Clear description of the records being released.
• Expiration Date: Indicate when the authorization will expire, if applicable.
• Signature: The student's signature and date of signing.

How to Obtain the Authorization for Release of Medical Records

Students can obtain the Authorization for Release of Medical Records from the student health center at UTK. This can typically be done by visiting the center in person or accessing the official student health center website. It's advisable to check if the form is available for download or if it must be filled out on-site. For any questions or assistance, students can contact the health center directly.

Examples of Using the Authorization for Release of Medical Records

There are various scenarios in which a student may need to use the Authorization for Release of Medical Records:

• Transferring to a new healthcare provider who requires previous medical history.
• Providing records to an insurance company for claims processing.
• Sharing health information with a family member for support during treatment.

Each of these situations requires careful completion of the authorization to ensure that the right information is shared with the appropriate parties.