HIPAA Authorization Form Template

Every patient needs an annual HIPAA Authorization Form on file to protect health information and adhere to the law. Collect signed forms easily by sending and receiving them electronically. Patients can complete or update this form anytime, anywhere with a phone, tablet, or computer.
hipaa-authorization-form

HIPAA Authorization Form Template

Give your patients the freedom to complete HIPAA authorization forms with any device, anywhere. Streamline the way you collect required signatures and complete patient files by setting up your form online.

Easily personalize this form template with a HIPAA compliant form builder.

Build a HIPAA compliant form for free

Start saving time and money with FormDr

What is the HIPAA Authorization Form?

Each patient is authorized to designate who the clinic can disclose health information to, as well as what exact information can be shared. The patient also needs to understand his/her rights under HIPAA laws. This form accomplishes all of that in one easy-to-update and customize form.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge.

The liability falls on you to handle patient data in a compliant way. Patient privacy is a serious topic, legislation from the Health Insurance Portability and Accountability Act to the Patient Protection and Affordable Care Act place heavy fines on medical professionals who mistreat patient information.

A medical release form does not empower your staff to share patient information with just anyone. Depending on what is included in the form, the document may release medical information to the patient’s family, other doctors, insurance providers, attorneys, or anyone who may make healthcare decisions on behalf of the patient.

Discover More Form Features

Setup HIPAA compliant online forms. Streamline your process of collecting information from patients.
HIPAA Compliant Online Intake Form Packets

Intake Form Packets

Combine multiple pages into an online form packet. Have your patients fill out their medical history, consent to treat, and demographics all in one new patient intake form packet.

Text Message Form Invites

Text Message Invitations

Send a text message invitation to your patients to complete your forms. Give patients the freedom to sign and complete forms with any device, anywhere.

Embed Forms on Website

Embed Forms on Website

Embed your forms directly on your website for a seamless experience for your patients. Your forms are customized with your logo, brand, and styling to match your site. Embed on Wordpress, Wix, Squarespace, and many more.

Print HIPAA Compliant Submissions

Print HIPAA Compliant Form Submissions

Print your patients’ submissions after the forms have been completed online. Adjust the formatting and text size to match your original paper forms.

They love FormDr - and so do their patients

  • Not having an online custom form to offer patients was a huge struggle. FormDr makes paperwork seamless and saves a ton of time and money by allowing us to upload to patients EMR rather than print, fill out, scan, and then attach. That is now a hindrance of the PAST!

    Woodlands Dermatology
    Angela H.
  • Patients can fill out the forms at their leisure, and don’t have to print anything. We’re collecting more completed forms than ever, and patients love not having to do anything when they come to the office for the first time.

    FYZICAL MetroWest
    Lauren A.
  • FormDr allows me to send and receive attractive, professional forms from patients. Very helpful that I can remind patients of their appointment time and check the status of the form.

    Banks Hepatology Institute PC
    Alpha B.
  • Sending a PDF was too time consuming for the patients to do, and it required the additional steps of printing and scanning it into our own systems. FormDr made it easier to get patients to complete the forms by email, and it’s a more secure way to provide info than simply emailing back a completed PDF.

    Reload Therapy
    Angie I.
  • Before FormDr, the most common struggle were our patients taking a long time to complete forms in our office. Now patients are able to be seen faster when forms are completed prior to visit. Very easy service to create forms online!

    Skin Science Dermatology
    Courtney M.
  • The support is second to none. FormDr has been instrumental in streamlining our intake of new patients.

    Lang Orthodontics
    Eric L.
  • Before, clients weren’t signing our forms before the appointment. FormDr has allowed us to share our documents for client review and signatures. I really appreciate the support, it has been super helpful simplifying our forms!

    Meridian Behavioral Health
    Laura W.

Book a Free Consultation

Schedule a consultation with us to learn more

FormDr gives your practice everything needed to easily send and receive HIPAA compliant forms online. We help practices who:

  • Are having patients fill out paper forms during the appointment
  • Are emailing patients a PDF or Word Doc to print out, fill out, scan, and send back
  • Are spending time manually printing and scanning paper forms