HIPAA Forms

Below you will find Health Insurance Portability & Accountability Act (HIPAA), Privacy Requirements and Medical Authorization forms from each carrier where available.

Aetna
Aetna HIPAA FAQ Form
AetnaHIPAA Form
Aetna Privacy Rules

Atlantis
Atlantis Health History Coverage Form

Cigna
Cigna HIPAA Form

GHI
GHI Authorization Form

Healthnet
HealthNet Disclosure Form

HealthPass
HealthPass Business Associate Agreement

HIP
HIP Health Information Form
HIP HIV Health Information Form
HIP Phych Health Information Form

Horizon BCBS NJ
Horizon Authorization Disclosure Form

LIA Health Alliance
LIA HIPAA Form

Oxford
Oxford Member HIPAA Authorization Form

Oxford Notice of Privacy Practices

United Healthcare
United Healthcare HIPAA Form

 NY State Department of Insurance HIPAA Information