DOEA Form 182 Authorization to Use or Disclose Health Information - Florida

What Is DOEA Form 182?

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

FAQ

Q: What is Form 182?
A: Form 182 is the Authorization to Use or Disclose Health Information form in Florida.

Q: What is the purpose of Form 182?
A: The purpose of Form 182 is to authorize the use or disclosure of an individual's health information.

Q: Who needs to fill out Form 182?
A: The individual whose health information is being disclosed or used needs to fill out Form 182.

Q: When is Form 182 used?
A: Form 182 is used when an individual wants to give permission for their health information to be shared with others.

Q: How should Form 182 be filled out?
A: Form 182 should be filled out completely and accurately, including the specific information about what health information can be disclosed and to whom.

Q: Is there a fee to submit Form 182?
A: No, there is no fee to submit Form 182.

Q: How long is Form 182 valid for?
A: Form 182 is usually valid for 90 days, but it can have a different duration depending on the specific circumstances.

Q: Can I revoke a previously signed Form 182?
A: Yes, you can revoke a previously signed Form 182 at any time by notifying the healthcare provider in writing.