Policy for Consent to Share Information with Family Members or Friends
There is a federal law called the Health Insurance Portability and Accountability Act of 1996 (HIPAA) that sets out rules for health care providers about who can look at and receive your health information. The HIPAA Privacy Rule ensures that you have rights over your health information.
Under HIPAA your health care provider may share your information face-to-face, over the phone, or in writing if:
- You give your provider permission
- You are present when the information is givern and do not object to sharing the information
- You are not present, and the provider determines, based on professional judgement, that it is in your best interest to share information
You have a right to confidentiality; however, you may wish other members of your family, a carer or a close friend who might be involved in your care, to be able to talk to the doctors and staff about your care on your behalf. This can be particularly useful if you find it difficult to get to the surgery, or if communication is difficult for you (such as hearing problems).
By completing one of these, this will allow you to enable us to share information about your care with the person you specify on the form. We need both you and the person who you would like us to share your information with to sign this form.
If you have more than one person you would like to give permission for us to share information with, please fill out a seperate form for each one and return to the surgery.
On receipt of the completed form, your wishes, together with details of the nominated person will be recorded in your record.
Consent to Share Form