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All patient personal and medical information is protected by HIPAA. Health Insurance Portability & Accountability Act restricts access to protected health information by anyone not involved in treatment, payment, and health care operations without the patient's permission.

Some examples are:

Name

Address

Telephone number 

Birthday 

Medicaid number and other medical records number 

Social security number

Name of employer

The HIPAA law list specific requirements that an authorization form must meet.

Individuals that request the disclosure of their protected health information are urged to use the following authorization form that meets HIPAA requirements.