Form IHS-913 Request for an Accounting of Disclosures

Form IHS-913 Request for an Accounting of Disclosures

What Is Form IHS-913?

This is a legal form that was released by the U.S. Department of Health and Human Services - Indian Health Service on April 1, 2009 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form IHS-913?
A: Form IHS-913 is a request for an accounting of disclosures.

Q: Who can use Form IHS-913?
A: Anyone who wants to request information about the disclosure of their health information can use Form IHS-913.

Q: What is an accounting of disclosures?
A: An accounting of disclosures is a record that shows who has received or accessed your health information.

Q: Why would someone request an accounting of disclosures?
A: Someone may request an accounting of disclosures to find out who has received their health information and for what purpose.

Q: Do I need to pay to submit Form IHS-913?
A: No, there is no fee to submit Form IHS-913.

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Form Details:

  • Released on April 1, 2009;
  • The latest available edition released by the U.S. Department of Health and Human Services - Indian Health Service;
  • Easy to use and ready to print;
  • Yours to fill out and keep for your records;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form IHS-913 by clicking the link below or browse more documents and templates provided by the U.S. Department of Health and Human Services - Indian Health Service.

Download Form IHS-913 Request for an Accounting of Disclosures

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  • Form IHS-913 Request for an Accounting of Disclosures, Page 1
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