Form DHCS6247 Authorization for Release of Protected Health Information to Third Parties - California

What Is Form DHCS6247?

This is a legal form that was released by the California Department of Health Care Services - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the DHCS6247 form?A: DHCS6247 is a form used in California to authorize the release of protected health information to third parties.

Q: Why would I need to use the DHCS6247 form?A: You would need to use the DHCS6247 form if you want to give permission for your health information to be shared with third parties.

Q: Who can request my health information with the DHCS6247 form?A: Third parties such as insurance companies, healthcare providers, or legal entities may request your health information with your authorization on the DHCS6247 form.

Q: Can I choose which information to release with the DHCS6247 form?A: Yes, you can specify which information you want to authorize for release on the DHCS6247 form.

Q: How can I obtain the DHCS6247 form?A: You can obtain the DHCS6247 form from your healthcare provider, insurance company, or the California Department of Health Care Services.

Q: Is the DHCS6247 form specific to California?A: Yes, the DHCS6247 form is specific to California and used within the state.

Q: Do I need to pay a fee to use the DHCS6247 form?A: There is usually no fee to use the DHCS6247 form, but additional charges may apply for obtaining copies of your health records.

Q: Can I revoke the authorization on the DHCS6247 form?A: Yes, you can revoke the authorization on the DHCS6247 form at any time by notifying the authorized party in writing.