The CDCR 7385 form is the official California Department of Corrections and Rehabilitation authorization for releasing protected health information. Patients, inmates, and authorized representatives use this document to request that medical, dental, mental health, or substance use disorder data be transferred to a named person or organization.
The authorization has eight sections. Section I identifies the patient and the correctional facility. Section II names the organization authorized to release the data. Section III names the recipient. Section IV defines which protected health information will be shared, including medical services, dental care, mental health treatment, communicable disease data, and other specified patient information. Section V sets the time period for the release. Section VI lists the exact items to be disclosed. Section VII states the purpose, such as personal use, legal proceedings, or continued health care. Section VIII contains the authorization statement and patient signature.
Patients have the right to revoke this authorization in writing at any time before health information is actually released. Federal law and California state law protect against unauthorized re-disclosure of released patient data. Psychotherapy notes require a separate authorization process. For related documents, see our Medical Records Request Form, County Corrections Department Form, or Central Registry Release of Information.
| Question | Answer |
|---|---|
| Form Name | Cdcr 7385 Form |
| Form Length | 4 pages |
| Fillable? | Yes |
| Fillable fields | 71 |
| Avg. time to fill out | 15 min 16 sec |
| Other names | cdcr authorization form, 7385 authorization, cdcr medical release form 7385, cdcr release of information 7385 |