HomeWho We AreQualityServicesLocationsDoctorsJobsGive Back
Go to Services Overview
Support Services
Billing and Insurance
Registration and Appointments
Medical Care Decisions
Advance Directives
Ethics Committee
Lifeline
Organ and Tissue Donation
Patient Bill of Rights & Responsibilities
Patient Privacy (HIPAA)
Health Information Disclosure
Interpreter Services
Chaplaincy Services
MyChart
Forsyth Medical Center Medical Care Decisions

Health Information Disclosure

A patient may choose to authorize disclosure of their health or billing information to a third party.

Authorization Form

Download the Authorization to Disclose Health or Billing Information Form.

Download

You have the right to release your personal information

Under Federal law, Forsyth Medical Center can only release your personal health information to those directly involved with providing your care. However, you have the right to grant access to your personal medical or billing information to other individuals or organizations of your choice. If you choose to do so, we require a written authorization.

Related Information

Notice of Privacy Practices
Keyword Search
Ways to Give
Maps & Directions
Pre-register for a Procedure
Find a Doctor
Insurance Acceptance
Pay Your Bill Online
Financial Assistance
Health Library
MyChart: Your secure online health record
Learn More About Ask Me 3
Forsyth Medical Center
©2011 - 2012 Novant Health - 3333 Silas Creek Parkway, Winston-Salem, North Carolina 27103, 336-718-5000
Email Us|Employee Connections|MD Links|Trustees|Novant Intranet|Legal Information|Disclaimer|Notice of Privacy|Novant Health