Form MADS-MR-LP Authorization to Release Protected Health Information (Large Print) - Massachusetts

What Is Form MADS-MR-LP?

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

FAQ

Q: What is the MADS-MR-LP Authorization form?
A: The MADS-MR-LP Authorization form is a document used in Massachusetts to request the release of protected health information in a large print format.

Q: Why would someone need to use this form?
A: This form is used when an individual needs their protected health information to be released in a larger print format for better readability.

Q: Who can use the MADS-MR-LP Authorization form?
A: Any individual in Massachusetts who needs their protected health information released in large print can use this form.

Q: Is there a fee for using this form?
A: There may be a fee associated with processing the request for releasing protected health information in large print, which can vary depending on the healthcare provider.

Q: What information is needed to fill out the form?
A: The form requires the individual's name, date of birth, contact information, healthcare provider information, and a description of the information to be released in large print.

Q: How long does it take to process the request?
A: The processing time for the request may vary, but it is recommended to contact your healthcare provider or the Massachusetts Department of Public Health for an estimate.

Q: Can the form be used for multiple requests?
A: Yes, the MADS-MR-LP Authorization form can be used for multiple requests as long as the information and purpose of the request remain the same.