Form B Request to Amend Protected Health Information - Alabama

What Is Form B?

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

FAQ

Q: What is a Form B?
A: Form B is a request to amend protected health information.

Q: What is protected health information?
A: Protected health information (PHI) includes any information about a patient's health or healthcare that is held or transmitted by a covered entity.

Q: Who can submit a Form B?
A: An individual or their personal representative can submit a Form B to request an amendment to their PHI.

Q: What information is required on the Form B?
A: The Form B requires the individual's identification information, a description of the amendment requested, and a reason for the request.

Q: What happens after submitting a Form B?
A: After submitting a Form B, the covered entity will review the request and either approve or deny the amendment.

Q: Is there a deadline to submit a Form B?
A: There is no specific deadline to submit a Form B, but it is recommended to do so as soon as possible.

Q: Are there any fees associated with submitting a Form B?
A: There are no fees associated with submitting a Form B to amend protected health information.