Form HS-2939 HIPAA Authorization for Release of Medical / Health Information to 3rd Party - Tennessee

Form HS-2939 HIPAA Authorization for Release of Medical / Health Information to 3rd Party - Tennessee

What Is Form HS-2939?

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

FAQ

Q: What is Form HS-2939?
A: Form HS-2939 is the HIPAA Authorization for Release of Medical/Health Information to 3rd Party specifically for Tennessee.

Q: What is HIPAA?
A: HIPAA stands for Health Insurance Portability and Accountability Act, a federal law that protects the privacy of individuals' medical information.

Q: Who can use Form HS-2939?
A: Any individual in Tennessee who wishes to authorize the release of their medical or health information to a third party can use Form HS-2939.

Q: Why would someone need to use this form?
A: This form is used when an individual wants to grant permission for their medical or health information to be shared with a specific third party, such as a family member, attorney, or healthcare provider.

Q: Is this form specific to Tennessee?
A: Yes, Form HS-2939 is specifically designed for use in Tennessee.

Q: Are there any fees associated with submitting this form?
A: There may be fees associated with submitting this form, depending on the specific healthcare provider or institution. It is recommended to inquire about any applicable fees before submitting the form.

Q: How long does it take for the authorization to be processed?
A: The processing time for the authorization may vary depending on the healthcare provider or institution. It is advisable to contact them directly for an estimated processing time.

Q: Is this form legally binding?
A: Yes, once signed and properly executed, this form is legally binding and authorizes the release of medical or health information to the designated third party.

Q: Can I revoke the authorization?
A: Yes, you can revoke the authorization at any time by submitting a written revocation to the healthcare provider or institution that received the original authorization.

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Form Details:

  • Released on June 1, 2018;
  • The latest edition provided by the Tennessee Department of Human Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form HS-2939 by clicking the link below or browse more documents and templates provided by the Tennessee Department of Human Services.

Download Form HS-2939 HIPAA Authorization for Release of Medical / Health Information to 3rd Party - Tennessee

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  • Form HS-2939 HIPAA Authorization for Release of Medical / Health Information to 3rd Party - Tennessee, Page 1
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