Access to a loved one’s health information

Get what you need to manage your family’s health care.


We are committed to protecting your health information. At some point during your care, you may need to share your health information with someone else — or, access a family member’s information.

Completing our authorization form gives Sharp Health Plan permission to share your personal health information. You control who you want to share that information with, and the level of information that you what to share with them. There are two options for you to choose from on the form:

  • Option 1: All health information (includes medical and financial information)
    • Medical — e.g., diagnoses, doctors, treatments
    • Financial — e.g., medical claims, bills, copayments
  • Option 2: Only limited information that you specify

DESCARGAR EL FORMULARIO

If you are legally responsible for making medical decisions for a parent or adult dependent, you will need to submit this form in order to access their health information.


Important note

This authorization form is for Sharp Health Plan only.

You will need to fill out additional authorization forms and submit them to your medical group, doctor’s office or locations where you receive care. We encourage you to contact your doctor’s office for more information.


How do I get my medical group’s authorization form?

You can find your medical group on your member ID card.

Sharp Community Medical GroupContact your doctor’s office
Sharp Rees-Stealy Medical GroupSee Authorization to release medical records
Greater Tri-Cities IPA:Call 1-800-458-2307 to ask for a special authorization form
Red de proveedores independientesContact your doctor's office
Primary Care Associates Medical GroupSee Disclosure of protected health information
Rady / Children’s Physicians Medical GroupSee Your child’s medical records
SCMG Arch Health Medical GroupSee Authorization to release PHI to designated persons
SCMG Graybill Medical GroupSee Permission to discuss protected health information with others in registration packet

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