Legal Forms

(Not intended as individual legal advice, these forms are for informational purposes only. Please consult your personal legal advisor.)

University Related

Release of Academic Information

Release of Medical Records and Authorization

Camp, Activity or Trip Release and Indemnification Agreement

Talent Release Form

HIPPA

Consent to Use and Disclosure of Protected Health Information for Purposes of Treatment, Payment, and Health Care Operations

Authorization When Health Care Provider Request Use or Disclosure for Its Own Use of Protected Health Care Information

Authorization When Patient Requests Use or Disclosure of Protected Health Information

Authorization Allowing Disclosure of Protected Health Information to Third Parties Other Than the Patient and Other Than for Use and Disclosure by Health Care Provider Itself

Request by Patient for Access to Protected Health Information

Response to Request for Access or Copying of Protected Health Information

Patient's Request for Accounting of Disclosures of Protected Health Information

Response to Request for Accounting of Disclosures of Protected Health Information

Request for Amendment of Protected Health Information

Response to Request for Amendment

Patient's Request for Additional Privacy Protections/Special Communication Requests

Fort Hays State University's Response to Request for Additional Privacy Protections/Special Communication Requests

Personal

Power of Attorney

Notice of Revocation of Power of Attorney

Power of Attorney for Children's Issues

Durable Power of Attorney

Please note that nothing contained within this site and the related links may be construed as "legal advice" from the Office of General Counsel. The materials presented are for informational purposes only.