PDF
Word
Form DHCS1807 Authorization for Release of Protected Health Information and Confidential Information - California
What Is Form DHCS1807?
This is a legal form that was released by the California Department of Health Care Services - 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 the DHCS1807 form?
A: The DHCS1807 form is the Authorization for Release of Protected Health Information and Confidential Information in California.
Q: What is the purpose of the DHCS1807 form?
A: The purpose of the DHCS1807 form is to authorize the release of protected health information and confidential information in California.
Q: Who needs to fill out the DHCS1807 form?
A: The DHCS1807 form needs to be filled out by individuals who want to give consent for their protected health information and confidential information to be released.
Q: What information is included in the DHCS1807 form?
A: The DHCS1807 form includes information about the individual who is authorizing the release of information, the specific information to be released, and the purpose of the release.
Q: Are there any fees associated with submitting the DHCS1807 form?
A: There are typically no fees associated with submitting the DHCS1807 form, but it is always best to check with the DHCS for any specific requirements or fees.
Q: How long does it take for the DHCS1807 form to be processed?
A: The processing time for the DHCS1807 form may vary, but it is advisable to submit the form well in advance of when the information needs to be released.
Q: Can the DHCS1807 form be used for multiple releases of information?
A: No, the DHCS1807 form is typically valid for a single release of information. A new form may need to be filled out for each subsequent release.
Q: What are the consequences of not submitting the DHCS1807 form?
A: If the DHCS1807 form is not submitted, the individual's protected health information and confidential information may not be released to the requested party or entity.
Q: Is the DHCS1807 form specific to California?
A: Yes, the DHCS1807 form is specific to the state of California.
Form Details:
- Released on June 1, 2013;
- The latest edition provided by the California Department of Health Care 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 DHCS1807 by clicking the link below or browse more documents and templates provided by the California Department of Health Care Services.
Download Form DHCS1807 Authorization for Release of Protected Health Information and Confidential Information - California
1
2
3
