Willows Unified School District

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Medical Forms | HIPAA Forms

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Medical Authorization Form

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Federal privacy standards to protect patients' medical records and other health information took effect in 2004 under the Health Insurance Portability and Accountability Act (HIPAA).

To maintain the privacy of your health information, It is the policy of Willows Unified School District to receive written authorization from a patient prior to releasing or utilizing healthcare information.

HIPAA Authorization Form - English (Authorization for Use or Disclosure of Health Information to School Districts)

Willows Unified School District

Address: 823 West Laurel St., Willows, CA 95988
Phone: 530.934.6600
Fax: 530.934.6609

Non-Discrimination Policy

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