Form CHFS-305 Authorization for Disclosure of Protected Information - Kentucky

Form CHFS-305 Authorization for Disclosure of Protected Information - Kentucky

What Is Form CHFS-305?

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

FAQ

Q: What is Form CHFS-305?
A: Form CHFS-305 is the Authorization for Disclosure of Protected Information specific to Kentucky.

Q: What is the purpose of Form CHFS-305?
A: The purpose of Form CHFS-305 is to give consent for the release of protected information in Kentucky.

Q: Who can use Form CHFS-305?
A: Form CHFS-305 can be used by individuals or their authorized representatives.

Q: What information can be disclosed with Form CHFS-305?
A: Form CHFS-305 allows for the disclosure of protected health, mental health, and substance abuse information.

ADVERTISEMENT

Form Details:

  • Released on August 1, 2019;
  • The latest edition provided by the Kentucky Department for Community Based 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 CHFS-305 by clicking the link below or browse more documents and templates provided by the Kentucky Department for Community Based Services.

Download Form CHFS-305 Authorization for Disclosure of Protected Information - Kentucky

4.5 of 5 (27 votes)
  • Form CHFS-305 Authorization for Disclosure of Protected Information - Kentucky

    1

  • Form CHFS-305 Authorization for Disclosure of Protected Information - Kentucky, Page 2

    2

  • Form CHFS-305 Authorization for Disclosure of Protected Information - Kentucky, Page 1
  • Form CHFS-305 Authorization for Disclosure of Protected Information - Kentucky, Page 2
Prev 1 2 Next
ADVERTISEMENT

Related Documents