{"product_id":"california-hipaa-authorization-template","title":"California HIPAA Authorization \/ Release Template","description":"\u003cp\u003e\u003cstrong\u003eCalifornia HIPAA Authorization \/ Release Template\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eA California HIPAA Authorization \/ Release template with completion notes and the blank form. California adults and caregivers who want family members to be able to talk with doctors and get medical records.\u003c\/p\u003e\n\u003ch3\u003eWhat's included\u003c\/h3\u003e\n\u003cul\u003e\u003cli\u003e\n\u003cstrong\u003eHIPAA Authorization \/ Release\u003c\/strong\u003e (9 pages): lets the people named receive protected health information from doctors, hospitals and health plans. Built on the federal core elements (45 C.F.R. §164.508) and California's Civil Code §56.11 rules, including 14-point type. Includes a separate stand-alone psychotherapy-notes authorization and a revocation form.\u003c\/li\u003e\u003c\/ul\u003e\n\u003cp\u003eEach document starts on its own page with plain-English completion notes, followed by the blank form. Where California law supplies a form, the statutory wording is reproduced verbatim.\u003c\/p\u003e\n\u003ch3\u003eSigning requirements (California)\u003c\/h3\u003e\n\u003cul\u003e\u003cli\u003eHIPAA Authorization \/ Release: signature and date only; no witnesses or notary are required.\u003c\/li\u003e\u003c\/ul\u003e\n\u003ch3\u003eFile formats\u003c\/h3\u003e\n\u003cp\u003eEditable Word (.docx) and print-ready PDF (US Letter) for every document, delivered as a ZIP digital download. Nothing is shipped.\u003c\/p\u003e\n\u003cp\u003eLegal research last verified September 29, 2026.\u003c\/p\u003e\n\u003cp\u003e\u003cem\u003eThis is a fill-in template, not legal advice. Laws change; check your state's current requirements before signing.\u003c\/em\u003e\u003c\/p\u003e\n\u003cp\u003eLicensed to the original purchaser for personal use only; not for resale or redistribution.\u003c\/p\u003e\n\u003cp\u003e\u003cem\u003eSome content in this template was drafted with the help of AI tools and reviewed before listing.\u003c\/em\u003e\u003c\/p\u003e","brand":"Rexford Mercantile","offers":[{"title":"Default Title","offer_id":67609558646938,"sku":"CALIFORNIA_HIPAA_AUTHORIZATION_TEMPLATE","price":12.0,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0750\/8531\/6250\/files\/california-hipaa-authorization-template-01-cover.jpg?v=1790717420","url":"https:\/\/rexfordmercantile.com\/products\/california-hipaa-authorization-template","provider":"Rexford Mercantile","version":"1.0","type":"link"}