Form PERS-BSD-35 Authorization to Disclose Protected Health Information - California

What Is Form PERS-BSD-35?

This is a legal form that was released by the California Public Employees' Retirement System - 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 Form PERS-BSD-35?
A: Form PERS-BSD-35 is an Authorization to Disclose Protected Health Information specific to California.

Q: What is the purpose of Form PERS-BSD-35?
A: The purpose of Form PERS-BSD-35 is to obtain permission for the sharing of an individual's protected health information in California.

Q: Who needs to fill out Form PERS-BSD-35?
A: Any individual who wants their protected health information to be disclosed in California needs to fill out Form PERS-BSD-35.

Q: What information is required on Form PERS-BSD-35?
A: On Form PERS-BSD-35, you would need to provide your personal information and specify the purpose and scope of the disclosure of your protected health information.

Q: Who is authorized to receive protected health information with Form PERS-BSD-35?
A: Only individuals or entities specified by the form are authorized to receive the protected health information.

Q: Is Form PERS-BSD-35 applicable in states other than California?
A: No, Form PERS-BSD-35 is specific to California and may not be applicable in other states.

Q: Can Form PERS-BSD-35 be used for disclosure of non-health-related information?
A: No, Form PERS-BSD-35 is specifically for the disclosure of protected health information and not for other types of information.