Item #: 1679673 | Model #: DLF551-SL
Adams® HIPAA Authorization (Patient), 1-Use Interactive Digital Legal Form
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Adams® HIPAA Authorization (Patient), 1-Use Interactive Digital Legal Form

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Delivered by Wed, Sep 19
$9.99
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Product Details
  • Lists person or persons allowed access to your health information for an unlimited or designated time period
  • Specifies level of access to include or exclude mental health, addiction, or communicable disease treatment
  • Attorney-reviewed form valid for use in every state
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9.99
9.99
https://www.staples-3p.com/s7/is/image/Staples/m003904281
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Adams
Adams® HIPAA Authorization (Patient), 1-Use Interactive Digital Legal Form
Product Description
The Adams online interactive forms let you instantly create high-quality legal documents tailored to your needs. These forms are powered by DirectLaw smart forms technology.

This form allows patients to create their own legal document granting designated family or friends access to their protected health information under the Health Insurance Portability and Accountability Act (HIPAA).

  • Lists person or persons allowed access to your health information for an unlimited or designated time period
  • Specifies level of access to include or exclude mental health, addiction, or communicable disease treatment
  • Attorney-reviewed form valid for use in every state
  • Click the secure link in your email from Staples to begin the interactive Q&A that creates your legal form
  • Online Guidance Notes offer additional information on signing, filing, and executing your documents
  • Download to save and print your customized PDF file
  • Valid for every state
  • Easy-to-follow questionnaire
  • After completing your online questionnaire, document is instantly available
  • Download completed forms after online assembly
  • Web browser: Microsoft Internet Explorer 7.0 or higher , Mozilla Firefox , Google Chrome , Safari 6.0 and earlier , Android standard browser
  • Print as many copies as you need
  • Step-by-step instructions included
  • Legal forms created by attorneys

This website provides legal forms only. We do not provide legal advice. Proper filing and service of documents and payment of related notary, court and filing fees are the responsibility of the purchaser. The legal documents offered from this website are intended to be used within thirty (30) days from the time of purchase.

Works with Microsoft Internet Explorer 7.0 or higher , Mozilla Firefox , Google Chrome, Safari 6.0 and earlier, and Android standard web browsers

Specifications
Legal Form Class Estate Planning
Legal Form Type Power of Attorney
Digital or Preprinted Form Digital Form
Pack Qty 1
Image File Formats PDF
Browser Microsoft Internet Explorer 7.0 or higher, Mozilla Firefox, Google Chrome, Safari 6.0 and earlier and Android standard web browsers
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