When is a DSHS 14-012(x) Consent form necessary?

The DSHS 14-012(x) consent form is a Health Insurance Portability and Accountability Act (HIPAA) compliant form designed for use by the client to authorize an exchange of information outside of basic eligibility information shared with an AREP. See AREP definition above. The 14-012(x) is the correct form for authorizing the sharing of specified confidential information between specified parties for a specified period of time.

HIPAA restrictions prevent us from discussing the client's individual health information with an AREP unless a current signed DSHS 14-012(x) consent form is in the record.