Question

Procedure 17-2 Completing a Release of Record Form for a Release of Information Tasks: Apply HIPAA rules and complete a release of record form for a release of information. Equipment and Supplies: • Records release form (electronic or paper) (See Work Product 17-1) • Patient record Scenario: Aaron Jackson was seen at Walden Hospital for a high fever. You need to help Aaron's mother complete a record release form so his record from the emergency department visit can be sent to the clinic. She needs to request all records from the visit on the first of this month. The clinic information is on the form. The release expires in 1 month Aaron's information DOB: 10/17/2011 SSN: 164-72-4618 Address: 555 McArthur Avenue, Anytown, AL 12345-1234 Phone: (123) 814-7844 Mother: Patricia Jackson Walden Hospital's information Address: Walden Hospital 123 Healing Way Anywhere, AL 12345-1234 Phone: (123) 814-4563 Fax: (123) 814-6544