C-4200, Applicant/Recipient Authorization

Revision 11-4; Effective December 1, 2011

The applicant/recipient may authorize the release of his or her health information from HHSC records by using a valid authorization form. Form H1003 , Appointment of an Authorized Representative, includes all the authorization elements required by HIPAA privacy regulations. See Section C-3000 , When and What Information May Be Disclosed, for the elements necessary for a valid authorization.