The Department of Health and Human Services (DHHS) Form 505 was created to help organizations comply with the HIPAA Privacy Rule. The form is used to request protected health information (PHI) from a covered entity. The DHHS Form 505 should be completed by the individual or organization requesting PHI, and must include the reason for the request and the specific information that is needed. Completed forms can be sent to the covered entity by mail, fax, or email.
| Question | Answer |
|---|---|
| Form Name | Dhhs Form 505 |
| Form Length | 6 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 1 min 30 sec |
| Other names | FM 505 sc dept of health and human services form 505 |
