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How Do I Create a HIPAA Release Form?

Creating a HIPAA release form is essential for therapists in private practice to ensure compliance with the Health Insurance Portability and Accountability Act (HIPAA). This form, also known as a HIPAA release authorization form or more commonly known to therapists the Release of Information form (ROI), allows clients to give their explicit permission to share their protected health information (PHI) with designated individuals or entities. 


To create a compliant HIPAA release form, you’ll need to include specific elements that align with HIPAA regulations, ensuring both the client’s privacy and your practice’s legal protection.


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What is the Difference Between a HIPAA Privacy Notice and a HIPAA Release Authorization Form/Release of Information?


You are probably wondering what are the different types of HIPAA forms when it comes to your private practice. 


A HIPAA Privacy Notice is a document that outlines how a therapist or a healthcare provider will protect a client’s PHI. It informs clients of their rights regarding their health information, including how their data will be used, stored, and shared. This notice must be provided to clients on their first visit and should detail the client’s rights to access, amend, and restrict their PHI. It also covers the practice’s obligations to safeguard this information.  

Looking for a FREE Attorney Approved HIPAA Privacy Notice for your private practice, CLICK HERE


On the other hand, a HIPAA Release Authorization Form, also known as a Release of Information Form (ROI), is a document that clients sign to authorize the release of their PHI to specified third parties. This form is used when a client needs their health information shared with another healthcare provider, insurance company, or any other entity. 


Unlike the privacy notice, which is a general document outlining practices and protections, the release authorization form is a specific consent document that must be completed and signed each time a client wishes to share their PHI with a third party.


What Makes a HIPAA Release Form/Release of Information Form Compliant?


As private practice therapists, we outline below a HIPAA form template for your Release of Information Form is compliant, it must include the following key elements:


  1. Client Information: The form should clearly state the client’s full name and other identifying information to ensure that the correct person’s PHI is being released.

  2. Recipient Information: The form must specify the name or organization to which the information will be disclosed. A different form should be used for each person or organization. Avoid listing out more than 1 person or organization as that in itself could violate confidentiality. 

  3. Description of Information: The form should clearly describe the information being released, whether it’s the entire medical record or specific parts, verbal communication only for collaboration, requesting a psychological evaluation, etc. 

  4. Purpose of Disclosure: The form should include the reason for releasing the information, whether it’s for treatment, collaboration, or other purposes.

  5. Expiration Date: A compliant form must state when the authorization expires. This can be a specific date or an event (e.g., "until the end of treatment").

  6. Client Signature: The form must be signed and dated by the client. If the client is a minor or unable to sign, their legal representative must sign the form.  The form MUST be signed by the client to release or request any information!

  7. Right to Revoke: The form should inform clients of their right to revoke the authorization at any time, in writing, and how they can do so.


If you are curious about what goes into a HIPAA Privacy Notice we cover this in another blog and give guidelines for your HIPAA privacy form template click here.


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Can Release of Information Forms Be Signed Electronically?


Yes, release of information forms can be signed electronically. In fact, electronic signatures are legally recognized under the Electronic Signatures in Global and National Commerce Act (E-SIGN Act) and the Uniform Electronic Transactions Act (UETA). Many therapists use Electronic Health Records (EHRs) and they get their forms signed electronically. 


For therapists in private practice, especially those who do telehealth therapy, this means that clients can sign HIPAA release forms online, making the process more convenient and efficient. However, it’s important to ensure that the electronic signature process complies with HIPAA’s security requirements, such as using secure, HIPAA-compliant platforms that authenticate the signer and protect the integrity of the document.


Looking for a FREE HIPAA Form for Therapists in Private Practice?


As a therapist in private practice, ensuring that your forms are HIPAA-compliant is crucial for protecting your clients’ privacy and maintaining your legal and ethical obligations. If you’re looking for a convenient and reliable solution, we offer free HIPAA forms online for therapists in private practice. You can upload it into your EHR or as a free printable HIPAA form.


These forms are designed to meet all HIPAA requirements and can be easily customized to suit your practice’s specific needs. Get your free HIPAA Privacy Form for counselors today by visiting Private Practice Startup and you can also purchase the Release of Information as well, CLICK HERE. All forms are attorney-reviewed and approved!


By ensuring that your HIPAA Privacy Notice Form and Release of Information form and other documentation are compliant and up-to-date, you protect your clients’ privacy and fortify your practice against potential legal risks. 


What Additional Forms Are Needed for a Counseling Private Practice?


In addition to HIPAA forms, there are numerous other essential forms that every therapist in private practice must have. At The Private Practice Startup, our Peak Package of attorney-approved paperwork offers a comprehensive collection of these forms, ensuring that your practice is well-equipped to handle all aspects of client care and legal compliance. The package includes:


Explore the full range of forms included in our Peak Package by visiting Private Practice Startup.


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Ready to Ensure Compliance with a HIPAA Release Form and Private Practice Paperwork?


Creating a compliant HIPAA release form is critical for therapists in private practice to protect client privacy and adhere to the Health Insurance Portability and Accountability Act (HIPAA). The Private Practice Startup offers a detailed Release of Information (ROI) form designed to meet all HIPAA requirements, along with a comprehensive private practice paperwork package to support your practice. Follow these three simple steps to get started:


  1. Ask Any Questions – Reach out to us at Kate@ThePrivatePracticeStartup.com if you have any questions or need further clarification about HIPAA release forms or any other essential documents.


  1. Download Your Free Template or Bundle – Access our attorney-approved HIPAA Privacy Form for free, or upgrade to our full private practice paperwork bundle, which includes a customizable Release of Information form and much more to keep your practice compliant.


  1. Start Using It Today – Simply input your practice’s details, and begin using HIPAA-compliant forms that protect your clients’ privacy and secure your legal standing.


Other Services Offered by The Private Practice Startup


At The Private Practice Startup, we are dedicated to helping your private practice thrive. Along with our extensive private practice paperwork package tailored for mental health professionals, we also provide specialized supervision forms to fit your unique requirements. Want to expand your practice? Our comprehensive Private Practice Marketing E-Course offers step-by-step guidance to help you attract more clients. Plus, one-on-one coaching with Kim Grocher, PhD, LCSW, provides targeted support to accelerate your professional growth. Be sure to tune in to the Private Practice Startup Podcast, where you’ll gain insights from industry experts, thriving therapists, and successful entrepreneurs. Whether you’re practicing in Texas, New York, or anywhere in between, we’re here to help you achieve your goals.

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