Form PERS-BSD-35 Authorization to Disclose Protected Health Information - California

What Is Form PERS-BSD-35?

This is a legal form that was released by the California Public Employees' Retirement System - 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 PERS-BSD-35?
A: Form PERS-BSD-35 is an Authorization to Disclose Protected Health Information specific to California.

Q: What is the purpose of Form PERS-BSD-35?
A: The purpose of Form PERS-BSD-35 is to obtain consent from the individual to disclose their protected health information.

Q: Who uses Form PERS-BSD-35?
A: Form PERS-BSD-35 is typically used by healthcare providers, insurance companies, and other covered entities in California.

Q: What information is required on Form PERS-BSD-35?
A: Form PERS-BSD-35 requires the individual's name, contact information, specific information to be disclosed, the purpose of the disclosure, and the expiration date of the authorization.

Q: Is Form PERS-BSD-35 mandatory in California?
A: While the use of Form PERS-BSD-35 is common in California, its use may vary depending on the healthcare provider or organization. It is recommended to check with the specific entity regarding their authorization process.