Form WCB-220 Limited Release of Medical / Health Care Information - Maine

What Is Form WCB-220?

This is a legal form that was released by the Maine Workers' Compensation Board - a government authority operating within Maine. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the Form WCB-220 Limited Release of Medical/Health Care Information?
A: Form WCB-220 is a document used in Maine to authorize the release of limited medical or health care information.

Q: Who uses the Form WCB-220 Limited Release of Medical/Health Care Information?
A: This form is typically used by individuals or entities who want to obtain specific medical or health care information from a provider.

Q: What information is released with the Form WCB-220?
A: The form allows for the release of limited medical and health care information, such as diagnosis, treatment, and medical history.

Q: Who should complete the Form WCB-220?
A: The individual or entity seeking the release of medical or health care information should complete this form.

Q: Is there a fee for submitting the Form WCB-220?
A: There is no fee mentioned on the form itself, but you should check with the Maine Workers' Compensation Board or your provider for any potential fees.

Q: Can I use the Form WCB-220 for purposes other than workers' compensation?
A: Yes, the form can be used for other purposes beyond workers' compensation, as long as it is authorized by the individual or entity seeking the information.

Q: Are there any restrictions on the use of the information obtained through Form WCB-220?
A: Yes, the use of the information is subject to the applicable laws and regulations governing the release and privacy of medical or health care information.

Q: How long is the Form WCB-220 valid?
A: The form does not specify an expiration date, so it is advisable to check with the Maine Workers' Compensation Board or your provider for any specific validity period.

Q: Can the Form WCB-220 be revoked?
A: Yes, the individual or entity who authorized the release of information can revoke it in writing at any time, unless it has already been acted upon.