Form DOC13-035 Authorization for Disclosure of Health Information - Washington

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Form DOC13-035 Authorization for Disclosure of Health Information - Washington

What Is Form DOC13-035?

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

FAQ

Q: What is Form DOC13-035?A: Form DOC13-035 is the Authorization for Disclosure of Health Information specifically used in the state of Washington.

Q: Why do I need to fill out Form DOC13-035?A: You need to fill out Form DOC13-035 to authorize the disclosure of your health information to a specific individual or entity.

Q: Who can I authorize the disclosure of my health information to using Form DOC13-035?A: You can authorize the disclosure of your health information to any individual or entity that you specify on Form DOC13-035.

Q: What type of health information can be disclosed using Form DOC13-035?A: Form DOC13-035 allows for the disclosure of all types of health information, including medical records, test results, and treatment plans.

Q: Is there a fee to submit Form DOC13-035?A: No, there is no fee to submit Form DOC13-035.

Q: Can I revoke or cancel the authorization made on Form DOC13-035?A: Yes, you can revoke or cancel the authorization made on Form DOC13-035 at any time by submitting a written request to the individual or entity you authorized.

Q: How long is the authorization valid on Form DOC13-035?A: The authorization on Form DOC13-035 is typically valid for one year, unless you specify a different expiration date on the form.

Q: What happens if I don't fill out Form DOC13-035?A: If you don't fill out Form DOC13-035, your health information cannot be disclosed to any individual or entity without your explicit consent.

Q: Can I use Form DOC13-035 for any type of healthcare provider?A: Yes, you can use Form DOC13-035 to authorize the disclosure of your health information to any healthcare provider in Washington.

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Form Details:

  • Released on July 27, 2022;
  • The latest edition provided by the Washington State Department of Corrections;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form DOC13-035 by clicking the link below or browse more documents and templates provided by the Washington State Department of Corrections.

Download Form DOC13-035 Authorization for Disclosure of Health Information - Washington

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