HIPAA Release Forms: Everything You Need to Know
Discover when you need a HIPAA release form, how to create one, and what’s at stake if you get it wrong.
Health Insurance Portability and Accountability Act (HIPAA) compliance is a layered system. It covers how health data is stored, who has access, what gets documented, and when disclosures are allowed. Some of those disclosures happen behind the scenes, like billing or internal audits. But others involve third-parties—family members, attorneys, schools, employers. It's in this context that HIPAA release forms become relevant.
A HIPAA release form gives patients the power to say, “Yes, you can share my information,” and draws a legal boundary around that permission. Without it, even well-meaning disclosures can violate the HIPAA Privacy Rule, triggering fines, investigations, and reputational damage.
If your organization handles health data—whether you’re building digital tools, managing employee benefits, or partnering with healthcare providers—you need to understand when a HIPAA release form is required, what it has to include, and how to handle it properly.
What Is a HIPAA Release Form?
A HIPAA release form (or HIPAA authorization form or consent form) is a signed document that gives a covered entity (i.e. a doctor’s office or hospital) permission to share a patient’s protected health information (PHI) with a third party.
In plain terms, it’s how patients give legal consent for their medical information to be shared with third-parties, such as a family member, a law firm, an employer, or a school. Without this authorization, the HIPAA Privacy Rule prohibits most disclosures. That means no emailing records to a parent, no sending files to an insurer, and no confirming details to an employer unless the form is signed and on file.
New to HIPAA? We’ve created a HIPAA compliance checklist resource to help you kick off your compliance journey.
When Do You Need a HIPAA Release Form?
A HIPAA release form is required when a covered entity shares a patient’s protected health information (PHI) with someone outside of treatment, payment, or healthcare operations. Common scenarios where a signed release form is required include:
Sharing medical records with a family member. A healthcare professional can't send test results to a spouse or parent unless the patient has given written permission.
Sending records to an insurance company or attorney. Legal or financial disclosures for a claim, case, or benefit require patient consent.
Providing information to an employer or school. Whether it's for workplace accommodations or enrollment in school activities, HIPAA requires written authorization.
On the flip side, a release form isn’t required when PHI is shared for treatment (e.g., sharing PHI between a primary care physician and a specialist), payment (e.g., submitting records to a health plan for reimbursement), or healthcare operations (e.g., quality assessments, audits, or staff performance reviews). If a disclosure falls outside these categories, a HIPAA release form is the legal requirement, not a best practice.
What Must Be Included in a HIPAA Release Form?
Each form must include the following core elements in order to meet HIPAA regulations:
Name or class of the person or entity disclosing the information. The covered entity sharing the data (often a hospital, clinic, insurer, healthcare organization, or healthcare provider).
Name or class of the person or entity receiving the information. A named person (“Jane Doe, caseworker at XYZ Insurance”) or a defined group (“legal team at ABC Law”).
Description of what’s being released. Patients must specify exactly what information they’re allowing to be disclosed. This could be “lab results from June 2025,” “all billing records,” or “entire medical file.”
Purpose of the disclosure. Clarifies why the information is being shared. Common reasons include “to support a workers’ compensation claim,” “at my request,” or “for legal representation.”
Expiration date or expiration event. The form needs a clear endpoint. That could be a fixed date (“December 31, 2025”) or a condition (“upon completion of surgery recovery” or “90 days from the date of signature”).
The signature of the patient (or their legal representative) and date of signature make the authorization official. If someone other than the patient is signing (e.g., a parent, guardian, or power of attorney), their legal authority must be documented and included.
Statement about the right to revoke. Patients have to be told they can cancel the authorization at any time.
Statement on conditional treatment or benefits. The form must state that the covered entity may not condition treatment, payment, enrollment, or eligibility for benefits on the patient’s decision to sign the authorization, unless the authorization is for research-related treatment or enrollment in a health plan. If those exceptions apply, they have to be clearly stated.
Step-by-Step Guide: How to Draft a HIPAA Release Form
Even small errors on a HIPAA release form can make it invalid. Here’s how to create a simple (and compliant) form that patients will have no issues filling out.
Step 1: Identify the Patient and the Individual or Entity Authorized to Disclose PHI
This is where the chain of custody begins. If there’s confusion about who is disclosing the information, the form can’t be enforced, and the disclosure could be considered unauthorized.
The patient should be identified by full legal name, and the form must name the person or organization allowed to disclose the PHI. This is typically a healthcare provider, hospital system, insurer, or other covered entity.
Example:
“I, Jane Doe, authorize Dr. Charlie Wellington at Porto Orthopedics to release the information listed below to the person(s) or organization(s) specified in this form under Section D.”
Step 2: Specify What PHI Will Be Shared
The description needs to be detailed enough for both the disclosing entity and the recipient to know exactly what’s included. Use categories like:
Type of information (e.g., lab results, discharge summaries, imaging)
Dates of service (e.g., visits between January and March 2024)
Specific conditions (e.g., treatment related to a shoulder injury)
Example:
“I permit the individual or covered entity above to disclose physical therapy progress notes, treatment plans, and discharge summary from July 1 to September 30, 2025.”
Precision here protects everyone: the patient, the discloser, and the recipient. It also reduces the risk of sharing more than the patient intended, which can create legal and ethical issues down the line.
Step 3: Identify the Recipient
This section identifies who will receive the protected health information (PHI) once it’s disclosed. The recipient must be clearly identified to avoid misrouting or unauthorized access. If it's a person, include their full name and (if possible) an organization or role. If it’s a group, like an insurance company or law firm, name the company and include a title or department.
Examples:
“John Doe, caseworker at ABC Insurance”
“Legal team at Marshall & Tonks LLP”
“Athletic Department at Houston High School”
“Human Resources Department, Stat Corp”
Step 4: State the Purpose of the Disclosure
This section explains why the patient’s information is being shared. You don’t need a paragraph, just a concise explanation that reflects the actual reason for the disclosure. It can be broad (“legal purposes”) or very specific (“supporting a short-term disability claim”). What matters is that it reflects the patient’s intent and gives the covered entity a legitimate reason to process the release.
Examples:
“To submit supporting documents for a workers’ compensation claim.”
“For continuity of care with a new primary care physician.”
“At the request of the individual.”
Step 5: Set an Expiration Date
Every HIPAA release form has to include a clear expiration to limit how long the authorization remains active. Once that date or event passes, the covered entity must stop disclosing the patient’s PHI under that form. You can use a calendar date, a timeframe, or a condition or event.
Examples:
“This authorization expires on October 15, 2025.”
“This authorization is valid for 60 days from the date of signature.”
“This authorization will expire once my employment accommodation request is processed.”
Step 6: Add Revocation Language
An explanation that the patient can revoke the authorization at any time gives them control over future disclosures and sets a clear process for withdrawal of consent.
The revocation must be submitted in writing, and it only applies to disclosures that haven’t happened yet. Any information already shared while the authorization was active remains valid.
Example:
“I understand that I may revoke this authorization in writing at any time. I also understand that my revocation will not affect any disclosures made before it was received.”
Step 7: Include a Statement About Conditions and Limitations
HIPAA requires that the form tell patients whether signing the authorization is a condition of receiving treatment, benefits, or enrollment. In most cases, it’s not, and the form must say so.
However, there are two exceptions:
A healthcare provider may require authorization to release PHI as a condition for receiving research-related treatment.
A health plan may require authorization for enrollment or eligibility.
If either of these conditions applies, it must be explicitly stated on the form.
Example language:
“I understand that [Provider Name] may not condition my treatment, payment, enrollment, or eligibility for benefits on whether I sign this authorization. However, I understand that refusal to sign may affect my eligibility for research-related treatment or enrollment in a health plan if applicable.”
Step 8: Obtain the Patient’s Signature
A HIPAA release form isn’t valid without a signature. This is the patient’s formal approval, and the legal basis for disclosing their health information.
The person signing the form must either be the patient or a legal representative authorized to act on the patient’s behalf. If a representative signs (e.g., a parent, legal guardian, or someone with medical power of attorney), the form has to clearly state their relationship to the patient and include documentation of their authority.
Examples:
Patient signature: John Doe (signed)
Representative signature: Mary Doe (signed) Legal guardian of John Doe
What Happens If You Don’t Use a Release Form?
If you or someone within your organization discloses PHI without proper patient authorization, you have to determine whether it qualifies as a reportable breach under HIPAA. That decision hinges on a risk assessment that evaluates whether there’s more than a “low probability” that the patient’s data was compromised.
You must consider these four factors:
What type of PHI was disclosed and the likelihood of re-identification
What was included? Could it reasonably identify someone?
Who received it
Was it another covered entity or someone unauthorized?
Whether the information was actually accessed or just received
Or was it just sent but never opened?
How the risk has been mitigated
For instance, was the information immediately secured or destroyed?
If the answer points to any meaningful risk, you’re required to notify the affected individual(s). For more serious incidents (affecting 500 or more individuals), you also need to notify the Department of Health and Human Services (HHS) and inform the media (in the region where the individual(s) reside).
From there, things can escalate. The HHS Office for Civil Rights (OCR) may launch an investigation. They’ll request documentation, review your internal controls, and ask to see the signed release form. If it’s missing or incomplete, there’s no gray area—your organization is in violation of HIPAA.
Penalties vary based on severity and history. Fines range from $100 to $50,000 per violation, with an annual cap of $1.5 million.
However, reputational damage can start long before penalties are imposed. Patients lose trust, partners get spooked, and prospects delay contracts or back out entirely. For companies selling into healthcare, one unauthorized disclosure can stall a deal or shut it down altogether.
When the stakes are this high, manual processes aren’t enough. A single oversight—one missing signature, one expired form—can trigger investigations, fines, and lasting damage to your reputation. You need a system that handles the details for you consistently, securely, and at scale.
Get HIPAA Compliance Right With Drata
HIPAA compliance calls for clear documentation, consistent processes, and proof that your controls actually work. Drata automates the pieces most teams manage manually. From access controls to evidence collection, our platform connects to your tech stack and gives you real-time visibility into your HIPAA compliance posture.
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HIPAA Release Forms Frequently Asked Questions (FAQs)
Still have questions about HIPAA release forms? Here are quick answers to some of the most common queries.
Why Are HIPAA Release Forms Important?
HIPAA release forms protect patient privacy and ensure that health information isn’t shared without permission. They create a legal record of consent, defining the scope of the disclosure and limiting who can access the information. For covered entities, the form provides clear boundaries for what’s allowed. For patients, it offers control and transparency over how their data is used.
Without proper authorizations, even well-intentioned disclosures can trigger HIPAA violations, fines, and loss of trust.
What Is the Difference Between a HIPAA Release Form and an Authorization?
There’s no difference—these terms refer to the same document and they both describe a signed document that allows for the disclosure of PHI by a covered entity to someone outside treatment, payment, or healthcare operations.
As long as the form meets HIPAA’s content requirements, either term is valid (and interchangeable in practice).
Do All Patients Need to Sign a HIPAA Release Form?
No. Patients only need to sign a HIPAA release form when their information is being shared outside of treatment, payment, or healthcare operations.
For example, a release form isn’t required when a primary care doctor refers a patient to a specialist, or when a provider bills an insurance company. But if a patient wants their records sent to a family member, attorney, school, or employer, written authorization is necessary.
HIPAA limits unnecessary disclosures, and the release form is what makes exceptions legally valid.
How Long Is a HIPAA Release Form Valid?
A HIPAA release form is valid until the expiration date or event listed on the form. The expiration can be a specific calendar date (e.g., “December 31, 2025”) or an event (e.g., “end of legal proceedings” or “completion of treatment”). If no expiration is listed, the form doesn’t meet HIPAA requirements and isn’t valid.
Covered entities are responsible for tracking expiration dates and stopping disclosures once the authorization is no longer active.
Does a HIPAA Release Form Expire?
Yes. Every HIPAA release form must include an expiration date or a specific event that triggers expiration. Once that date passes, or the event occurs, the form is no longer valid. Any disclosures made after that point would require a new authorization. This expiration requirement is what prevents long-term or open-ended access to a patient’s health information.
