This template gives you everything you need for a professional, customizable and legally binding Release Medical Hipaa Minor Child Agreement.
It allows healthcare providers to share a child's medical information with people other than the parents, like grandparents, stepparents, or caregivers. Useful when someone else might need to make medical decisions or access health records.
Anyone the parents choose to authorize, like grandparents, stepparents, babysitters, or other caregivers. The authorization should be specific about what information can be shared and for what purposes.
Usually by giving written notice to the healthcare provider. The revocation typically doesn't apply to information already shared under the previous authorization, but stops future disclosures.