Adams® HIPAA Authorization (Patient), 1-Use Interactive Digital Legal Form
Supplies and Accessories
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
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
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Legal Form Class
Legal Form Type
Power of Attorney
Digital or Preprinted Form
Image File Formats
Microsoft Internet Explorer 7.0 or higher, Mozilla Firefox, Google Chrome, Safari 6.0 and earlier and Android standard web browsers