Laser Spine Institute – Fill Out and Use This PDF

Laser Spine Institute PDF Details

The Laser Spine Institute (LSI), LLC provides a comprehensive approach to patient care and information handling through its Patient Authorization for Release of Medical Information form. This document plays a critical role in facilitating the seamless exchange of medical records between LSI and other healthcare entities or the patient themselves. Located at 3031 N. Rocky Point Drive, E., Tampa, FL, with contact details readily available, the form ensures that a patient's health information is shared securely, adhering to the preferences indicated by the patient—be it via mail, fax, or secure email. Patients are given the flexibility to request the transfer of all their records, including notes, labs, reports, and CDs, or specify particular documents. The form underscores a commitment to patient autonomy by allowing the authorization to remain effective indefinitely until revoked by the patient, their legal guardian, power of attorney, or healthcare surrogate. Detailed steps on how to revoke the authorization highlight the institute's dedication to upholding patient rights and maintaining confidentiality. Furthermore, the acknowledgment that the information may be re-disclosed once it leaves the institution’s hands serves as a transparent disclaimer about the limits of privacy once records are shared, emphasizing the extent and limitations of federal privacy laws. This authorization form underlines the LSI’s protocols, ensuring a patient-driven approach to health information management while confirming that treatments or payments are not contingent upon the authorization, except as permitted by law, thereby offering peace of mind and control to the patients over their medical records.