PDF
Word
Form C-3.3 Limited Release of Health Information (HIPAA) - New York
What Is Form C-3.3?
This is a legal form that was released by the New York State Workers' Compensation Board - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form C-3.3?
A: Form C-3.3 is the Limited Release of Health Information (HIPAA) form.
Q: What is the purpose of Form C-3.3?
A: The purpose of Form C-3.3 is to allow individuals to give limited consent to release their health information in compliance with HIPAA regulations.
Q: Is Form C-3.3 applicable in all states?
A: No, Form C-3.3 is specific to the state of New York.
Q: What type of health information can be released using Form C-3.3?
A: Form C-3.3 allows for the release of limited health information, such as specific diagnoses or treatment information.
Q: Who can use Form C-3.3?
A: Form C-3.3 can be used by individuals who want to authorize the release of their limited health information to specific individuals or entities.
Q: Is Form C-3.3 a legally binding document?
A: Yes, Form C-3.3 is a legally binding document that complies with HIPAA regulations in the state of New York.
Form Details:
- Released on December 1, 2009;
- The latest edition provided by the New York State Workers' Compensation Board;
- Easy to use and ready to print;
- Available in Spanish;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form C-3.3 by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board.
