Form PR-ENF-133 Medical Information Authorization - California

What Is Form PR-ENF-133?

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

FAQ

Q: What is Form PR-ENF-133?
A: Form PR-ENF-133 is a Medical Information Authorization form specific to the state of California.

Q: What is the purpose of Form PR-ENF-133?
A: Form PR-ENF-133 is used to authorize the release of medical information.

Q: Who needs to use Form PR-ENF-133?
A: Individuals who want to grant permission for their medical information to be shared or released.

Q: What information is required on Form PR-ENF-133?
A: The form typically requires the individual's name, date of birth, contact information, the date of authorization, and a description of the specific medical information being released.

Q: Can the information released with Form PR-ENF-133 be limited?
A: Yes, the individual can specify the scope of information being released by indicating the purpose of the release and any restrictions.

Q: Is Form PR-ENF-133 valid in states other than California?
A: Form PR-ENF-133 is specific to California, so it may not be valid in other states. Other states may have their own specific authorization forms.

Q: Is there a fee for using Form PR-ENF-133?
A: Fees may apply when requesting medical records, but the form itself does not typically have a fee associated with it.

Q: Can Form PR-ENF-133 be faxed or emailed?
A: In most cases, healthcare providers and organizations accept faxed or emailed copies of the form, although it is best to confirm with the specific recipient.

Q: How long is Form PR-ENF-133 valid for?
A: The validity period of the form may vary depending on the healthcare provider or organization. It is recommended to check with them for their specific requirements.