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Form C-3.3 Limited Release of Health Information (HIPAA) - New York (English / French)
What Is Form C-3.3?
This is a legal form that was released by the New York State Workers' Compensation Board - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form C-3.3?A: Form C-3.3 is a Limited Release of Health Information form.
Q: What does HIPAA stand for?A: HIPAA stands for Health Insurance Portability and Accountability Act.
Q: What is the purpose of Form C-3.3?A: The purpose of Form C-3.3 is to allow individuals to authorize the release of their health information.
Q: Who needs to use Form C-3.3?A: Individuals who want to authorize the release of their health information need to use Form C-3.3.
Q: Is Form C-3.3 specific to New York?A: Yes, Form C-3.3 is specific to New York.
Q: Is Form C-3.3 available in English and French?A: Yes, Form C-3.3 is available in both English and French.
Q: Can an individual revoke their authorization on Form C-3.3?A: Yes, an individual can revoke their authorization on Form C-3.3 at any time by submitting a written request.
Form Details:
- Released on December 1, 2009;
- The latest edition provided by the New York State Workers' Compensation Board;
- Easy to use and ready to print;
- Available in Spanish;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form C-3.3 by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board.
Download Form C-3.3 Limited Release of Health Information (HIPAA) - New York (English / French)
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