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HIPAA Authorization - Colorado

Colorado · Fillable PDF · Free

Federal privacy law (HIPAA) limits who doctors, hospitals, and insurers can talk to about you. This authorization lets the people you name receive your health information so they can help you. Federal privacy law (HIPAA) limits who doctors, hospitals, and insurers can talk to about you. This authorization lets the people you name receive your health information so they can help you.

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Who this form is for

Colorado residents and families reviewing hipaa authorization.

What you'll need

Read the supplied packet before completing its fields.
Follow this document's signing, identification and any witness instructions.

How to complete it

Who and what (Page 1) Name the people who may receive your information and choose what may be released. Initial any specially protected records you want included.
Sign before a notary (Page 2) Hospitals and insurers are more likely to accept a notarized authorization without question. Bring a current, government-issued photo ID.

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This is Colorado’s statutory form for directing what happens to your body after death, such as burial or cremation, and who arranges your funeral or memorial.

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This is a Colorado living will, called a “Declaration as to Medical or Surgical Treatment.” It tells your doctors not to artificially prolong your life if you have a terminal condition or are in a persistent vegetative state and cannot decide for yourself.

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A Colorado medical durable power of attorney names someone (your “agent”) to make health care decisions for you if you cannot. It does not cover finances.

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Revocation of Medical Durable Power of Attorney - Colorado

Use this form to cancel a Colorado medical durable power of attorney, a living will declaration, or both.

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These forms are a free convenience, not legal advice. First Choice Mobile Notary & Apostille is not a law firm. Consult an attorney licensed in the relevant state for legal questions.

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