Form SFN62213 Authorization for Consent and Use of Protected Health Information (Phi) - North Dakota

What Is Form SFN62213?

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

FAQ

Q: What is the purpose of Form SFN62213?
A: Form SFN62213 is used to obtain authorization for the consent and use of Protected Health Information (PHI) in North Dakota.

Q: What type of information does Form SFN62213 cover?
A: Form SFN62213 covers Protected Health Information (PHI), which includes medical records, test results, and other health-related information.

Q: Who needs to fill out Form SFN62213?
A: Any individual or organization that needs to obtain consent or use Protected Health Information (PHI) in North Dakota should fill out Form SFN62213.

Q: Is Form SFN62213 specific to North Dakota?
A: Yes, Form SFN62213 is specific to North Dakota and is used to comply with the state's laws and regulations regarding the consent and use of Protected Health Information (PHI).

Q: Is there a fee for submitting Form SFN62213?
A: There is no fee for submitting Form SFN62213; however, there may be fees associated with obtaining copies of medical records or other related services.

Q: Who can authorize the consent and use of Protected Health Information (PHI) on Form SFN62213?
A: The individual or legal representative (such as a parent or guardian) of the individual whose PHI is being disclosed can authorize the consent and use of PHI on Form SFN62213.

Q: How long is the authorization for consent and use of Protected Health Information (PHI) valid?
A: The authorization is valid for a specific period of time, which is typically specified on Form SFN62213. It may also include an expiration date or event.