Form WDVA4002 Authorization for Disclosure of Health Information - Wisconsin

What Is Form WDVA4002?

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

FAQ

Q: What is the Form WDVA4002?
A: Form WDVA4002 is the Authorization for Disclosure of Health Information in Wisconsin.

Q: What is the purpose of Form WDVA4002?
A: The purpose of Form WDVA4002 is to grant permission to disclose health information.

Q: Who needs to fill out Form WDVA4002?
A: Anyone who wants their health information to be disclosed needs to fill out Form WDVA4002.

Q: Is Form WDVA4002 specific to veterans?
A: While it is commonly used by veterans, Form WDVA4002 can be used by anyone in Wisconsin.

Q: Are there any fees associated with Form WDVA4002?
A: There are no fees associated with Form WDVA4002.

Q: How long is the authorization valid for?
A: The authorization is generally valid for one year, unless otherwise specified.

Q: Can I revoke the authorization?
A: Yes, you can revoke the authorization at any time by submitting a written revocation to the party who received the original authorization.

Q: What happens if I don't fill out Form WDVA4002?
A: If you don't fill out Form WDVA4002, your health information will not be disclosed without your explicit permission.

Q: Is Form WDVA4002 confidential?
A: Yes, Form WDVA4002 and the disclosed health information are treated as confidential.