This template has been reviewed and approved by the respective USC IRBs. See USC HIPAA Policy RES-301 for further information about using these forms. Instructions for completing HIPAA authorization form Must be provided to patient no later than first clinical encounter must be posted in conspicuous location at each clinical site*See USC Policy CLIN-200 for further information regarding use of the Notice of Privacy Practices. USC and DHS agreement to coordinate education effortsД®xplains the terms under which USC and Department of Health Services will accept the HIPAA education certification of the other institution. See USC Policy GEN-102 for further information regarding use of the authorization. This authorization form should be used and tailored for other uses and disclosures for which no other specific template document exists. Those specific authorization forms can be found below.

USC has developed specific template authorizations for uses/disclosures of health information for (1) research (2), fundraising (3) marketing and (4) special privacy considerations.

Questions about these policies should be directed to the USC Office of Culture, Ethics and Compliance at (213) 740-8258 or Also, see Cooperation with Compliance Investigations policy.Дated February 19, 2003, to university community regarding compliance with HIPAA privacy rule. The policies located on were developed to assist USC faculty and staff in complying with these regulations. Federal regulations, known as the Health Insurance Portability and Accountability Act (HIPAA) privacy law, generally prohibit the use and disclosure of health information without written permission from the patient.

Hipaa compliance forms for dental