Sample HiTech HIPAA Form for Patient Access to Affordable Medical Records
Updated: Dec 18, 2023
Note: This article is for general information only and is not legal advice to any particular reader or individual. For legal advice, you must specifically retain a lawyer who evaluates your specific situation.
For a downloadable PDF, that is form fillable (or printable and hand write-able, see here:
Here is what you will have:
For consideration for Attorney SSD/SSI representation in an upcoming or pending SSDI/SSI disability claim, please fill out our free Attorney Evaluation form. We do NOT charge a retainer to serve you.If, on the other hand, you only seek an attorney level consultation/analysis of a particular situation, whether you are a company or an individual, or to discuss your own situation without representation, to learn information beyond that information you may obtain for free from the SSA itself, and you do not otherwise have a lawyer representing your before the SSA, you may order a scheduled consultation at affordable attorney rates. Contact the office at 201-317-0610 or email email@example.com.