Authorization for Examination and Release of Information - New Mexico

Authorization for Examination and Release of Information is a legal document that was released by the New Mexico Department of Health - a government authority operating within New Mexico.

FAQ

Q: What is the Authorization for Examination and Release of Information form for?
A: The form is used to authorize the examination and release of medical information.

Q: Who needs to complete the Authorization for Examination and Release of Information form?
A: The person seeking medical treatment or their legal representative needs to complete the form.

Q: What information is included on the form?
A: The form will typically include the name of the person authorizing the release of information, the purpose of the release, the specific information to be released, and to whom the information should be released to.

Q: Is the form specific to New Mexico?
A: Yes, the form is specific to New Mexico and may contain state-specific requirements.

Q: Can the form be used for multiple purposes?
A: Yes, the form can be used to authorize the release of information for multiple purposes, such as for treatment, payment, or healthcare operations.

Q: Does the form expire?
A: The form may include an expiration date, after which it is no longer valid. Check the form for any expiration date specified.

Q: Can the release of information be revoked?
A: Yes, the person who authorizes the release of information can typically revoke the authorization at any time, in writing.

Q: Is the form confidential?
A: Yes, the information released through the form is typically kept confidential and protected by privacy laws, such as HIPAA.

Q: Can the form be used for minors?
A: For minors, the form may need to be completed by a parent or legal guardian.