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Release of Information

Health information is regarded as CONFIDENTIAL and available only to authorized users. Release of information from a medical record will be carried out in accordance with all applicable legal, accrediting, and regulatory agency requirements.

Release of Information without Authorization

As specified by law, an authorization is not required for UT Health Northeast to:

  • Verify that a person is a patient in the hospital/clinic, the dates of service, and the patient’s condition such as “good,” “fair,” “serious,” or “critical.”
  • Use and disclosure of health information for treatment of the patient, payment of services provided, or healthcare operations of UT Health.

Release of Information with Authorization

The use and disclosure of protected health information can be done only with the completion of an authorization form, and it must be signed by the patient or the patient’s legal representative.

The following individuals are permitted by law to authorize the disclosure of a patient’s healthcare information:

  • Parent or legal guardian of a minor
  • Legal guardian of a patient who has been judged incompetent to manage his or her personal affairs by a court
  • Agent of the patient under a medical power of attorney for healthcare
  • Attorney or guardian ad litem appointed for the patient by a court
  • Personal representative or statutory beneficiary of a deceased patient

Authorization Forms

To authorize UT Health Northeast to RELEASE information TO another person or facility, complete the Release of Information Release Form.

To authorize UT Health Northeast to RECEIVE information FROM another person or facility, complete the Release of Information Receive Form.

Contact Information

Business Hours: Monday – Friday, 8:00 a.m. – 4:30 p.m.
Telephone: (903) 877-7985
Fax: (903) 877-5123

Charges

By state law, UT Health Northeast is allowed to charge a fee as established by the state for the information provided. Our charges will not exceed the allowable fee structure. Typically, there will be no charge for information sent directly to another healthcare provider or facility for the continuing healthcare of the patient.

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