Agencies
Services
HIPAA Privacy Forms Numeric Listing
- HFS 3806 Notice of Privacy Practice (pdf)
- HFS 3806S Notice of Privacy Practice (pdf) (Spanish)
- HFS 3806D Authorization to Disclose Health Information (pdf)
- HFS 3806DS Authorization to Disclose Health Information (pdf) (Spanish)
- HFS 3806E Complaint about Health Information Uses and Disclosures (pdf)
- HFS 3806ES Complaint about Health Information Uses and Disclosures (pdf) (Spanish)
- HFS3806F Personal Representative Designation (pdf)
- HFS 3806FS Personal Representative Designation (pdf) (Spanish)
- HFS 3806G Request for an Accounting of Disclosures of Health Information (pdf)
- HFS 3806GS Request for an Accounting of Disclosures of Health Information (pdf) (Spanish)
- HFS 3806H Request to Amend Health Information (pdf)
- HFS 3806HS Request to Amend Health Information (pdf) (Spanish)
- HFS 3806I Request to Contact Client at a Different Address (pdf)
- HFS 3806IS Request to Contact Client at a Different Address (pdf) (Spanish)
- HFS 3806J Request to Restrict Uses and Disclosures of Health Information (pdf)
- HFS 3806JS Request to Restrict Uses and Disclosures of Health Information (pdf) (Spanish)
- HFS 3806K Authorization to Disclose All Kids/FamilyCare Information (pdf)
- HFS 3806KS Authorization to Disclose All Kids/FamilyCare Information (pdf) (Spanish)
- HFS 3806L Request for Access to Health Information (pdf)
- HFS 3806LS Request for Access to Health Information (pdf) (Spanish)