HIPAA Housing Provider Release

Federal Law requires us to obtain an individual’s written authorization for any use or disclosure of protected health information that is not for treatment, payment or health care operations or otherwise permitted or required by the Privacy Rule.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA)  prohibits us from responding or replying to your housing provider without your permission. In order to ensure a smoother verification process, you will need to provide us a signed waiver.

There’s no charge for this service.

Steps:

  1. Download the attached Authorization for use or disclosure of Protected Health Information
  2. Print, sign, and scan the form — saving a copy to your local computer
  3. Upload that scanned form to us (via our HIPAA cloud service)

Uploading your HIPAA waiver

Located below the yellow message input area are “three dots” … that’s the menu icon. Click that, a menu appears, select “upload file”, follow the directions.

HIPAA_AuthorizationForm